Provider Demographics
NPI:1396748323
Name:CAMPBELL, LAURA IVEY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:IVEY
Last Name:CAMPBELL
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 1:411 DERBYSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-1084
Mailing Address - Country:US
Mailing Address - Phone:423-587-9344
Mailing Address - Fax:
Practice Address - Street 1:272 HIGHWAY 11 E
Practice Address - Street 2:
Practice Address - City:BULLS GAP
Practice Address - State:TN
Practice Address - Zip Code:37711
Practice Address - Country:US
Practice Address - Phone:423-235-6263
Practice Address - Fax:423-235-4792
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10205183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist