Provider Demographics
NPI:1912051954
Name:DANIELSON, BARBARA DIANE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:DIANE
Last Name:DANIELSON
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 1:559 LONGVIEW
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:MT
Mailing Address - Zip Code:59242-9713
Mailing Address - Country:US
Mailing Address - Phone:406-963-2266
Mailing Address - Fax:
Practice Address - Street 1:304 S. ELLERY
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:MT
Practice Address - Zip Code:59221
Practice Address - Country:US
Practice Address - Phone:406-742-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2474183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist