Provider Demographics
NPI:1831646488
Name:MANSMAN, LAURA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:MANSMAN
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 1:25 KONA DR
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-1053
Mailing Address - Country:US
Mailing Address - Phone:301-996-8454
Mailing Address - Fax:
Practice Address - Street 1:77 DERRY RD.,
Practice Address - Street 2:HUDSON MALL
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051
Practice Address - Country:US
Practice Address - Phone:603-882-2301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR2146183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist