Provider Demographics
NPI:1548771256
Name:AMMONS, LAURA HALL
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:HALL
Last Name:AMMONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 STEPPING STONE LN
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786-7408
Mailing Address - Country:US
Mailing Address - Phone:828-550-5613
Mailing Address - Fax:
Practice Address - Street 1:479 DELLWOOD RD
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-2907
Practice Address - Country:US
Practice Address - Phone:828-452-2313
Practice Address - Fax:828-452-5451
Is Sole Proprietor?:No
Enumeration Date:2017-10-20
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27218183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist