Healthcare Provider Details

I. General information

NPI: 1255666442
Provider Name (Legal Business Name): CONNIE ELIZABETH SHAWLER RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2009
Last Update Date: 10/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7812 E SPEEDWAY BLVD
TUCSON AZ
85710-1649
US

IV. Provider business mailing address

7812 E SPEEDWAY BLVD
TUCSON AZ
85710-1649
US

V. Phone/Fax

Practice location:
  • Phone: 520-885-3540
  • Fax: 520-298-9264
Mailing address:
  • Phone: 520-885-3540
  • Fax: 520-298-9264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number8368
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: