Provider Demographics
NPI:1558645549
Name:BARNES, LAURA KAY (PHARMD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:KAY
Last Name:BARNES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3445 E WOODVILLE DR
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-7329
Mailing Address - Country:US
Mailing Address - Phone:208-761-1378
Mailing Address - Fax:
Practice Address - Street 1:1323 S MAPLE GROVE RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-1610
Practice Address - Country:US
Practice Address - Phone:208-319-0967
Practice Address - Fax:208-319-0970
Is Sole Proprietor?:No
Enumeration Date:2011-10-07
Last Update Date:2023-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP6560183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist