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General NPI Number Information
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NPI Number | 1326864612
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Entity Type | Individual
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Provider Name | SHANNON BLAISE LEIGHTON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 200 HAWTHORNE LN
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City | CHARLOTTE
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State | NC
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Zip | 28204-2515
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Country | US
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Telephone | 305-527-3488
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Fax |
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Provider Business Mailing Address
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Address Line | 200 HAWTHORNE LN
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City | CHARLOTTE
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State | NC
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Zip | 28204-2515
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Country | US
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Telephone |
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 700648
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | RPH-0019788
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License Number State | OR
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