Provider Demographics
NPI:1689994980
Name:MESHBERGER, LAURA ELISE (LAURA MESHBERGER)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ELISE
Last Name:MESHBERGER
Suffix:
Gender:F
Credentials:LAURA MESHBERGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7017 S PRIEST DR APT 1030
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-6066
Mailing Address - Country:US
Mailing Address - Phone:260-525-5255
Mailing Address - Fax:
Practice Address - Street 1:2420 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-7031
Practice Address - Country:US
Practice Address - Phone:602-268-7232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS017237183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist