Provider Demographics
NPI:1639772379
Name:DANISON, MICHELLE (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:DANISON
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5351 SOMERSET DR
Mailing Address - Street 2:
Mailing Address - City:HOLT
Mailing Address - State:MI
Mailing Address - Zip Code:48842-9516
Mailing Address - Country:US
Mailing Address - Phone:513-652-8895
Mailing Address - Fax:
Practice Address - Street 1:5609 W SAGINAW HWY
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-2456
Practice Address - Country:US
Practice Address - Phone:517-327-0620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03328689183500000X
MI5302412491183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist