Provider Demographics
NPI:1972881761
Name:SEAGROVES, LYNN DENISE (RPH)
Entity type:Individual
Prefix:MS
First Name:LYNN
Middle Name:DENISE
Last Name:SEAGROVES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3089
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27715-3089
Mailing Address - Country:US
Mailing Address - Phone:919-668-4110
Mailing Address - Fax:919-668-4108
Practice Address - Street 1:ERWIN ROAD CHC RM 1937
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-668-4110
Practice Address - Fax:919-668-4108
Is Sole Proprietor?:No
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11033183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist