Provider Demographics
NPI:1780991927
Name:ANDERSON, LAURA ANN (PHARM D)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:ANN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 HAILE MALONE RD
Mailing Address - Street 2:
Mailing Address - City:FARMERVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71241-5881
Mailing Address - Country:US
Mailing Address - Phone:318-376-8746
Mailing Address - Fax:
Practice Address - Street 1:1018 STERLINGTON HWY
Practice Address - Street 2:
Practice Address - City:FARMERVILLE
Practice Address - State:LA
Practice Address - Zip Code:71241-3810
Practice Address - Country:US
Practice Address - Phone:318-368-2218
Practice Address - Fax:318-368-2298
Is Sole Proprietor?:No
Enumeration Date:2010-09-09
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD10871183500000X
LA18475183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist