Provider Demographics
NPI:1447856083
Name:ENLOE, DANIELLE E (RPH)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:E
Last Name:ENLOE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9809 DIVINO CT
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:OK
Mailing Address - Zip Code:73007-2201
Mailing Address - Country:US
Mailing Address - Phone:314-602-3411
Mailing Address - Fax:
Practice Address - Street 1:1225 W I 35 FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-7394
Practice Address - Country:US
Practice Address - Phone:405-348-3677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK15100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist