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Individual

SUSAN MARY DANIELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
701 KEYSTONE AVE, RENO, NV 89503-4103
(775) 747-1628
Mailing address
3705 VISTA BLVD, SPARKS, NV 89436-6700
(815) 351-6414

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
051290128
IL
183500000X
Pharmacist
Primary
19313
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200926
NABP
Enumeration date
10/06/2016
Last updated
10/06/2016
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