Provider Demographics
NPI:1780365973
Name:PAIONE, AUDRA BERNICE (PHARMD)
Entity type:Individual
Prefix:
First Name:AUDRA
Middle Name:BERNICE
Last Name:PAIONE
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 1:1147 INN KEEPERS WAY
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-8166
Mailing Address - Country:US
Mailing Address - Phone:770-363-9249
Mailing Address - Fax:
Practice Address - Street 1:19815 N COVE RD
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-6445
Practice Address - Country:US
Practice Address - Phone:704-895-5075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32461183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist