Provider Demographics
NPI:1396090635
Name:RUSSELL, WHITNEY DANIELLE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:DANIELLE
Last Name:RUSSELL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:DANIELLE
Other - Last Name:NICHOLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1380 OLD HIGHWAY 24
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:AL
Mailing Address - Zip Code:35673-5600
Mailing Address - Country:US
Mailing Address - Phone:256-350-3365
Mailing Address - Fax:256-350-3366
Practice Address - Street 1:1380 OLD HIGHWAY 24
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:AL
Practice Address - Zip Code:35673-5600
Practice Address - Country:US
Practice Address - Phone:256-350-3365
Practice Address - Fax:256-350-3366
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-23
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36647183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist