=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427363142
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIELLE KATHERINE WINNER PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2010
-----------------------------------------------------
Last Update Date | 05/31/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10 MAIN ST
-----------------------------------------------------
City | SIDNEY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13838
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 607-563-2166
-----------------------------------------------------
Fax | 607-563-8828
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10 MAIN ST
-----------------------------------------------------
City | SIDNEY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13838-1135
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 607-563-2166
-----------------------------------------------------
Fax | 607-563-8828
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 0202209946
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 058013
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------