Provider Demographics
NPI:1629854104
Name:WHORLEY, LAURA MARIE (RPH)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:WHORLEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 S 63RD CIR APT 420
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-3043
Mailing Address - Country:US
Mailing Address - Phone:402-253-1795
Mailing Address - Fax:
Practice Address - Street 1:5203 LEAVENWORTH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-1807
Practice Address - Country:US
Practice Address - Phone:402-551-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE17945183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist