Provider Demographics
NPI:1770224925
Name:GRABER, DANNA HANKS (PHARMD)
Entity type:Individual
Prefix:
First Name:DANNA
Middle Name:HANKS
Last Name:GRABER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:DANNA
Other - Middle Name:LEA
Other - Last Name:HANKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:100 E IDAHO ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-6267
Mailing Address - Country:US
Mailing Address - Phone:208-381-4586
Mailing Address - Fax:
Practice Address - Street 1:100 E IDAHO ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83712-6267
Practice Address - Country:US
Practice Address - Phone:208-381-4586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-03
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY4417183500000X
IDP10190183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist