Provider Demographics
NPI:1487705927
Name:LAYMAN, TRACY LYNN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:LYNN
Last Name:LAYMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 HAZEL ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-2850
Mailing Address - Country:US
Mailing Address - Phone:417-358-4840
Mailing Address - Fax:417-358-8591
Practice Address - Street 1:1515 HAZEL ST
Practice Address - Street 2:SUITE 102
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-2850
Practice Address - Country:US
Practice Address - Phone:417-358-4840
Practice Address - Fax:417-358-8591
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001023401183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist