MEDICARE: MAKENZIE DANIELS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P2201X	Ambulatory Care Pharmacist	13411539-1701	UT

General Provider Information

NPI Number	:	1861342065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAKENZIE DANIELS

Provider Business Mailing Address
First Line	:	2294 S 2000 E # 2602
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-4139
Country	:	US
Telephone Number	:	270-780-7741
Fax Number	:

Provider Business Practice Location Address
First Line	:	3730 W 4700 S # 2602
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84129-3457
Country	:	US
Telephone Number	:	270-780-7741
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	01/29/2026

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