Provider Demographics
NPI:1629549027
Name:AYRES, LAURA NORWOOD
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:NORWOOD
Last Name:AYRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10721 CHAPMAN HWY
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:TN
Mailing Address - Zip Code:37865-4765
Mailing Address - Country:US
Mailing Address - Phone:865-609-1036
Mailing Address - Fax:
Practice Address - Street 1:10721 CHAPMAN HWY
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:TN
Practice Address - Zip Code:37865-4765
Practice Address - Country:US
Practice Address - Phone:865-609-1036
Practice Address - Fax:865-579-2638
Is Sole Proprietor?:No
Enumeration Date:2018-12-10
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X
TN44377183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No174H00000XOther Service ProvidersHealth Educator