Healthcare Provider Details

I. General information

NPI: 1124334651
Provider Name (Legal Business Name): DANA K CONNORS PHARM. D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2010
Last Update Date: 08/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9640 MENAUL BLVD NE
ALBUQUERQUE NM
87112-2217
US

IV. Provider business mailing address

9640 MENAUL BLVD NE
ALBUQUERQUE NM
87112-2217
US

V. Phone/Fax

Practice location:
  • Phone: 505-294-4167
  • Fax: 505-294-5229
Mailing address:
  • Phone: 505-294-4167
  • Fax: 505-294-5229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6647
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: