Provider Demographics
NPI:1285970723
Name:LAURICH, MICHELLE SIMPSON (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:SIMPSON
Last Name:LAURICH
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 1:2817 REILLY ST STOP A
Mailing Address - Street 2:INPATIENT PHARMACY
Mailing Address - City:FORT BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28310-7301
Mailing Address - Country:US
Mailing Address - Phone:910-585-0226
Mailing Address - Fax:
Practice Address - Street 1:2817 REILLY ST STOP A
Practice Address - Street 2:INPATIENT PHARMACY
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-7301
Practice Address - Country:US
Practice Address - Phone:910-585-0226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-02
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR2372183500000X
NC18409183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist