Provider Demographics
NPI:1811218209
Name:CANUPP, HOLLY CAUSEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:CAUSEY
Last Name:CANUPP
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:ELIZABETH
Other - Last Name:CAUSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:DUMC BOX 3089
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710
Mailing Address - Country:US
Mailing Address - Phone:919-477-5904
Mailing Address - Fax:919-477-3110
Practice Address - Street 1:4220 N. ROXBORO ROAD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704
Practice Address - Country:US
Practice Address - Phone:919-477-5904
Practice Address - Fax:919-477-3110
Is Sole Proprietor?:No
Enumeration Date:2010-06-20
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21025183500000X
NCNC210251835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist