Healthcare Provider Details

I. General information

NPI: 1467365122
Provider Name (Legal Business Name): NATALIE LY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1811 MATTHEWS TOWNSHIP PKWY
MATTHEWS NC
28105-4659
US

IV. Provider business mailing address

14544 REESE BLVD W
HUNTERSVILLE NC
28078-6898
US

V. Phone/Fax

Practice location:
  • Phone: 704-844-6822
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number33970
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: