Provider Demographics
NPI:1881421188
Name:HERRERA, DAYANNA GRACIELA (PHARMD)
Entity type:Individual
Prefix:
First Name:DAYANNA
Middle Name:GRACIELA
Last Name:HERRERA
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 1:1269 NEXTON PARKWAY
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486
Mailing Address - Country:US
Mailing Address - Phone:843-974-9474
Mailing Address - Fax:
Practice Address - Street 1:1269 NEXTON PARKWAY
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486
Practice Address - Country:US
Practice Address - Phone:843-974-9474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-19
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL67388183500000X
SC60368183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist