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General NPI Number Information
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NPI Number | 1902484314
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Entity Type | Individual
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Provider Name | DANIELLE HARRISON
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Gender | Female
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Dates
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Enumeration Date | 03/30/2021
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Last Update Date | 03/30/2021
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Provider Practice Location Address
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Address Line | 1795 E STATE ROAD 163
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City | CLINTON
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State | IN
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Zip | 47842-7327
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Country | US
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Telephone | 765-832-3539
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Fax |
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Provider Business Mailing Address
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Address Line | 9850 E STEWART AVE
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City | TERRE HAUTE
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State | IN
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Zip | 47805-9718
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Country | US
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Telephone | 812-229-3394
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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 | 26029121A
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License Number State | IN
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