Healthcare Provider Details

I. General information

NPI: 1386054179
Provider Name (Legal Business Name): DANIELLE WAYMEYER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2014
Last Update Date: 06/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 KENTON STATION DR
MAYSVILLE KY
41056-9617
US

IV. Provider business mailing address

305 COLGAN RD
WALLINGFORD KY
41093-8932
US

V. Phone/Fax

Practice location:
  • Phone: 606-759-0014
  • Fax:
Mailing address:
  • Phone: 513-498-5055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHA 0020032
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number016468
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number21600003
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: