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NPI Code Detail

MEDICARE: TRACIE LEE LAURENT PHARMD

MEDICARE: TRACIE LEE LAURENT PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist18118CO

General Provider Information

NPI Number : 1033701297
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACIE LEE LAURENT PHARMD
Provider Business Mailing Address
First Line : 455 HUNTER CT
Second Line :
City : BRIGHTON
State : CO
Zip : 80601-4360
Country : US
Telephone Number : 303-667-5748
Fax Number :
Provider Business Practice Location Address
First Line : 1919 QUENTIN ST
Second Line :
City : AURORA
State : CO
Zip : 80045-7125
Country : US
Telephone Number : 720-857-6422
Fax Number : 720-857-6509
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2021
Last Update Date : 02/09/2021

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Directions to “ TRACIE LEE LAURENT PHARMD” Practice Location

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