Provider Demographics
NPI:1164621231
Name:DANIEL, JACLYN PIEPER (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:JACLYN
Middle Name:PIEPER
Last Name:DANIEL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 DAWSON RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-3853
Mailing Address - Country:US
Mailing Address - Phone:229-436-1517
Mailing Address - Fax:229-439-8343
Practice Address - Street 1:1315 DAWSON RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-3853
Practice Address - Country:US
Practice Address - Phone:229-436-1517
Practice Address - Fax:229-439-8343
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023789183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist