Provider Demographics
NPI:1972997773
Name:LAMBERTSEN, COURTNEY EDWARDS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:EDWARDS
Last Name:LAMBERTSEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:COURTNEY
Other - Middle Name:BROOKE
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:921 LIBERTY LN
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-3073
Mailing Address - Country:US
Mailing Address - Phone:804-512-2179
Mailing Address - Fax:
Practice Address - Street 1:921 LIBERTY LN
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-3073
Practice Address - Country:US
Practice Address - Phone:804-512-2179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-19
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY014214183500000X
NC25598183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist