Provider Demographics
NPI:1174957831
Name:COLLIER, LAURIN BALLOWE (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:LAURIN
Middle Name:BALLOWE
Last Name:COLLIER
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:LAURIN
Other - Middle Name:
Other - Last Name:BALLOWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9640 LEESVILLE ROAD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613
Mailing Address - Country:US
Mailing Address - Phone:919-745-4938
Mailing Address - Fax:919-647-9198
Practice Address - Street 1:9640 LEESVILLE ROAD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613
Practice Address - Country:US
Practice Address - Phone:919-745-4938
Practice Address - Fax:919-647-9198
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14303183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist