Provider Demographics
NPI:1710369475
Name:BOE, LAURA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:BOE
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 1:6412 S PARKER RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-3011
Mailing Address - Country:US
Mailing Address - Phone:303-627-6111
Mailing Address - Fax:303-627-9475
Practice Address - Street 1:6412 S PARKER RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-3011
Practice Address - Country:US
Practice Address - Phone:303-627-6111
Practice Address - Fax:303-627-9475
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0020763183500000X
ND5387183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist