Healthcare Provider Details
I. General information
NPI: 1518394154
Provider Name (Legal Business Name): CHRISTIE DANNER PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/27/2013
Last Update Date: 09/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1501 SAN PEDRO DR SE NEW MEXICO VA HEALTH CARE SYSTEM - PHARMACY (119)
ALBUQUERQUE NM
87108-5153
US
IV. Provider business mailing address
1501 SAN PEDRO DR SE NEW MEXICO VA HEALTH CARE SYSTEM - PHARMACY (119)
ALBUQUERQUE NM
87108-5153
US
V. Phone/Fax
- Phone: 505-265-1711
- Fax:
- Phone: 505-265-1711
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | RP00007337 |
| License Number State | NM |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: