Provider Demographics
NPI:1568800472
Name:PROCTOR, LEAH ANN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LEAH
Middle Name:ANN
Last Name:PROCTOR
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10700 WORLD TRADE BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-4220
Mailing Address - Country:US
Mailing Address - Phone:800-571-3922
Mailing Address - Fax:800-571-3991
Practice Address - Street 1:10700 WORLD TRADE BLVD STE 110
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-4220
Practice Address - Country:US
Practice Address - Phone:800-571-3922
Practice Address - Fax:800-571-3991
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-13
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23231183500000X
FLPS52409183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist