Healthcare Provider Details

I. General information

NPI: 1881084366
Provider Name (Legal Business Name): MRS. LAURA NORMA BARKSDALE-HONORA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2015
Last Update Date: 02/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

436 LONGDALE CRES
CHESAPEAKE VA
23325-4337
US

IV. Provider business mailing address

436 LONGDALE CRES
CHESAPEAKE VA
23325-4337
US

V. Phone/Fax

Practice location:
  • Phone: 757-619-9385
  • Fax: 757-292-4734
Mailing address:
  • Phone: 757-619-9385
  • Fax: 757-292-4734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number0230002559
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: