Provider Demographics
NPI:1245443993
Name:IRWIN-PINKLEY, LAURIE SUSAN (NP)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:SUSAN
Last Name:IRWIN-PINKLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3892 SPRING GREEN RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27892-9071
Mailing Address - Country:US
Mailing Address - Phone:252-217-7765
Mailing Address - Fax:252-792-6615
Practice Address - Street 1:490 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23324-2618
Practice Address - Country:US
Practice Address - Phone:757-382-2630
Practice Address - Fax:757-382-2607
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC118658163W00000X
VA0024167219363L00000X
NCCNM 076367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Not Answered367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife