Provider Demographics
NPI:1659004943
Name:STORM, DAYLAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:DAYLAN
Middle Name:
Last Name:STORM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 JONES ST APT 234
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-1287
Mailing Address - Country:US
Mailing Address - Phone:405-388-9654
Mailing Address - Fax:
Practice Address - Street 1:981090 NEBRASKA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-1090
Practice Address - Country:US
Practice Address - Phone:402-836-9251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE171841835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology