Danielle Renee Deters, PHARMD

Individual provider Active NPI Pharmacist · Olney, IL

NPI 1689274136 · NPPES record last updated Oct 26, 2020

Key facts

NPI
1689274136
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
051.298306 (IL)
Practice address
1001 N West St
Olney, IL 62450-3774
Phone
(618) 392-3464
Fax
(618) 392-3260
NPI assigned
Oct 26, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051.298306ILMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.298306 IL Yes

Addresses

Primary practice location

1001 N West St
Olney, IL 62450-3774

Mailing address

1001 N West St
Olney, IL 62450-3774
Phone (618) 392-3464

Other names

  • Dr. Danielle Renee Deters Former name

Other providers in Olney, IL

All providers in Olney, IL · Pharmacist in Illinois

Sources for this page

Verify at the official NPI Registry.