Provider Demographics
NPI:1760138234
Name:GROBE, DANIKAH
Entity Type:Individual
Prefix:
First Name:DANIKAH
Middle Name:
Last Name:GROBE
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 1:26776 HIGHWAY 59
Mailing Address - Street 2:
Mailing Address - City:AVOCA
Mailing Address - State:IA
Mailing Address - Zip Code:51521-2506
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4500 SERGEANT RD
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-4705
Practice Address - Country:US
Practice Address - Phone:712-274-2949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA24256183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist