Provider Demographics
NPI:1710584495
Name:HUNTER, LAURA ELIZABETH (PHARMD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ELIZABETH
Last Name:HUNTER
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 1:130 EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:MAIDSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26541-8205
Mailing Address - Country:US
Mailing Address - Phone:304-646-6707
Mailing Address - Fax:
Practice Address - Street 1:9781 SENECA TRL S
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-1580
Practice Address - Country:US
Practice Address - Phone:304-645-7053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0012196183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist