Provider Demographics
NPI:1932541976
Name:KIRK, LAURA HUNTER (PHARMD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:HUNTER
Last Name:KIRK
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 1:1014 SMOKE WILLOW WAY
Mailing Address - Street 2:
Mailing Address - City:ROLESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27571-9735
Mailing Address - Country:US
Mailing Address - Phone:804-512-9580
Mailing Address - Fax:
Practice Address - Street 1:518 E NASH ST
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:NC
Practice Address - Zip Code:27549-2460
Practice Address - Country:US
Practice Address - Phone:919-496-4134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-18
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23598183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist