Provider Demographics
NPI:1447741541
Name:JUNE, DANIEL PAUL
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:PAUL
Last Name:JUNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5280 EAGLECREST DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-6247
Mailing Address - Country:US
Mailing Address - Phone:847-848-7682
Mailing Address - Fax:
Practice Address - Street 1:4835 KIETZKE LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6549
Practice Address - Country:US
Practice Address - Phone:775-829-7922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0015742183500000X
WA60720539183500000X
NV19430183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist