Provider Demographics
NPI:1568108280
Name:HAIRE, COURTNEY LEIGHANN (CPHT)
Entity Type:Individual
Prefix:MISS
First Name:COURTNEY
Middle Name:LEIGHANN
Last Name:HAIRE
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 BLAWELL ST
Mailing Address - Street 2:
Mailing Address - City:STEDMAN
Mailing Address - State:NC
Mailing Address - Zip Code:28391-9731
Mailing Address - Country:US
Mailing Address - Phone:910-584-1191
Mailing Address - Fax:
Practice Address - Street 1:715 BLAWELL ST
Practice Address - Street 2:
Practice Address - City:STEDMAN
Practice Address - State:NC
Practice Address - Zip Code:28391-9731
Practice Address - Country:US
Practice Address - Phone:910-584-1191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30007697183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician