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General NPI Number Information
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NPI Number | 1649760448
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Entity Type | Individual
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Provider Name | TIFFANY CONNER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/16/2018
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Last Update Date | 05/16/2018
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Provider Practice Location Address
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Address Line | 222 TONGASS DR
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City | SITKA
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State | AK
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Zip | 99835-9416
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Country | US
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Telephone | 907-966-8347
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Fax | 907-966-8450
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Provider Business Mailing Address
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Address Line | 106A BARLOW ST
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City | SITKA
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State | AK
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Zip | 99835-7616
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Country | US
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Telephone | 337-315-2493
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHA.0022015
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License Number State | CO
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