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General NPI Number Information
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NPI Number | 1063008878
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Entity Type | Individual
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Provider Name | DANIELLE TAYLOR PHARMACIST
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Gender | Female
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Dates
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Enumeration Date | 12/15/2020
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Last Update Date | 12/15/2020
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Provider Practice Location Address
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Address Line | 85 S HIGHWAY 92
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-3637
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Country | US
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Telephone | 520-439-6081
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Fax | 520-439-6083
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Provider Business Mailing Address
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Address Line | 1813 N SAN GABRIEL AVE
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-6208
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Country | US
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Telephone | 520-249-3273
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | S12387
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License Number State | AZ
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