Provider Demographics
NPI:1912303249
Name:PEARSON, VALLIE JANE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:VALLIE
Middle Name:JANE
Last Name:PEARSON
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 1:101 CARSON FARMS DR W
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-9322
Mailing Address - Country:US
Mailing Address - Phone:917-209-4708
Mailing Address - Fax:
Practice Address - Street 1:3611 GROOMETOWN RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-6525
Practice Address - Country:US
Practice Address - Phone:336-856-7437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-13
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24687183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist