Healthcare Provider Details
I. General information
NPI: 1114266590
Provider Name (Legal Business Name): MARY ABIGAIL SYKES PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/05/2013
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3001 E MARKET ST
GREENSBORO NC
27405-7525
US
IV. Provider business mailing address
3001 E MARKET ST
GREENSBORO NC
27405-7525
US
V. Phone/Fax
- Phone: 336-275-7657
- Fax:
- Phone: 336-275-7657
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174N00000X |
| Taxonomy | Lactation Consultant (Non-RN) |
| License Number | L-165955 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 21087 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: