Provider Demographics
NPI:1265765952
Name:MCDANIEL, DANNA LYNN (RPH)
Entity type:Individual
Prefix:
First Name:DANNA
Middle Name:LYNN
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 RATTLESNAKE ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28146-8768
Mailing Address - Country:US
Mailing Address - Phone:704-223-1450
Mailing Address - Fax:
Practice Address - Street 1:1505 E INNES ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28146-6018
Practice Address - Country:US
Practice Address - Phone:704-637-6864
Practice Address - Fax:704-637-6807
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-11
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14901183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist