Provider Demographics
NPI:1720501489
Name:LAWRENCE, JULIA POYNOR (PHARMACIST)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:POYNOR
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88201-1330
Mailing Address - Country:US
Mailing Address - Phone:575-626-1984
Mailing Address - Fax:
Practice Address - Street 1:2705 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-1330
Practice Address - Country:US
Practice Address - Phone:575-626-1984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-24
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00008941835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist