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General NPI Number Information
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NPI Number | 1972256568
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Entity Type | Individual
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Provider Name | DANIELLE WALLACE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 02/02/2022
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Last Update Date | 02/02/2022
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Provider Practice Location Address
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Address Line | 1005 DR DB TODD JR BLVD STE 332
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City | NASHVILLE
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State | TN
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Zip | 37208-3501
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Country | US
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Telephone | 154-392-6816
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Fax | 888-808-6014
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Provider Business Mailing Address
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Address Line | 1005 DR DB TODD JR BLVD STE 332
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City | NASHVILLE
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State | TN
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Zip | 37208-3501
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Country | US
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Telephone | 154-392-6816
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Fax | 888-808-6014
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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 | 21992
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS47604
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH027028
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 44923
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License Number State | TN
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