Provider Demographics
NPI:1285945717
Name:VAUGHN, LAURA MICHELLE (PHARMD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MICHELLE
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 CHANNEL DR STE 300
Mailing Address - Street 2:ETHEL LUND MEDICAL CENTER PHARMACY
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-7837
Mailing Address - Country:US
Mailing Address - Phone:907-463-4061
Mailing Address - Fax:
Practice Address - Street 1:3100 CHANNEL DR STE 300
Practice Address - Street 2:ETHEL LUND MEDICAL CENTER PHARMACY
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-7837
Practice Address - Country:US
Practice Address - Phone:907-463-4061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC211101835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy