Provider Demographics
NPI:1811101397
Name:RAYMER, DANIELLE WEEDEN (PHARMD, CPP)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:WEEDEN
Last Name:RAYMER
Suffix:
Gender:F
Credentials:PHARMD, CPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 CHARLOIS BLVD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-1508
Mailing Address - Country:US
Mailing Address - Phone:336-718-1222
Mailing Address - Fax:336-718-1589
Practice Address - Street 1:250 CHARLOIS BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1508
Practice Address - Country:US
Practice Address - Phone:336-718-1222
Practice Address - Fax:336-718-1589
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC135651835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy