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General NPI Number Information
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NPI Number | 1013372952
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Entity Type | Individual
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Provider Name | LAURA E HAYNES PHARMD
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Gender | Female
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Dates
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Enumeration Date | 12/18/2015
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Last Update Date | 08/15/2024
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Provider Practice Location Address
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Address Line | 1013 CEDAR ST STE B
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City | BISMARCK
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State | MO
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Zip | 63624-8901
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Country | US
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Telephone | 573-734-8588
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Fax | 888-626-5925
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Provider Business Mailing Address
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Address Line | 1004 W RIDGE RD
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City | BONNE TERRE
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State | MO
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Zip | 63628-8720
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Country | US
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Telephone | 314-803-2352
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2012023194
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License Number State | MO
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