Provider Demographics
NPI:1184459349
Name:HAIRE, LAURA ASHLEY (PA-C)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ASHLEY
Last Name:HAIRE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 HARTMAN DR
Mailing Address - Street 2:
Mailing Address - City:ANGIER
Mailing Address - State:NC
Mailing Address - Zip Code:27501-6869
Mailing Address - Country:US
Mailing Address - Phone:919-980-0702
Mailing Address - Fax:
Practice Address - Street 1:800 5TH ST
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24504-2848
Practice Address - Country:US
Practice Address - Phone:434-818-7880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-05
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant