Doctor Name: | DANNY ICENHOUR |
NPI Number: | 1063668010 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHARMD |
License Number: | 8313 |
Business Practice Address: | James H Quillen Va Medical Center Mountain Home, TN - 37684 |
Business Phone Number: | 4239261171 |
Business Fax Number: | |
Mailing Address: | James H Quillen Va Medical Center, MOUNTAIN HOME |
State: | TN |
Postal Code: | 37684 |
Phone Number: | 4239261171 |
Fax Number: | |
NPI Enumeration Date: | 08/11/2008 |
NPI Last Update Date: | 08/11/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1835P0018X |
License Number: | 8313 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Pharmacy Service Providers |
Taxonomy Classification: | Pharmacist |
Taxonomy Specialization: | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Taxonomy Definition: | Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |