Active NPI
Danielle Tully, RPH
- Pharmacist
- West Jefferson, NC
National Provider Identifier
1417548637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 30190
- Practice address
- 2 Crescent Dr
West Jefferson, NC 28694-7375 - Phone
- (336) 246-2790
- NPI assigned
- Jan 30, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 30190 | NC | Primary |
Addresses
Primary practice location
2 Crescent Dr
West Jefferson, NC 28694-7375
Mailing address
2 Crescent Dr
West Jefferson, NC 28694-7375
Phone (336) 246-2790
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30190 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611964800000",
"number": "1417548637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 CRESCENT DR",
"city": "WEST JEFFERSON",
"state": "NC",
"postal_code": "286947375",
"telephone_number": "336-246-2790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 CRESCENT DR",
"city": "WEST JEFFERSON",
"state": "NC",
"postal_code": "286947375",
"telephone_number": "336-246-2790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TULLY",
"first_name": "DANIELLE",
"name_prefix": "Dr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-30",
"last_updated": "2021-01-30",
"certification_date": "2021-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "30190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Jefferson, NC
- April Hall Taylor, DC
- The Jeffersons Drug Stores Inc
- The Mental Health Association in North Carolina, Inc.
- The Mental Health Association in North Carolina, Inc.
- The Village of Ashe Assisted Living Inc
- Whitney Vandenraadt, DPT
- Wal-Mart Stores East LP
- Wal-Mart Stores East, LP
- Shirley Anne Warner, FNP-C
- WJ Medical Associates
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.