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NPI Code Detail

MEDICARE: SUSAN KONEZNY PHARMD

MEDICARE: SUSAN KONEZNY PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist118218MN

General Provider Information

NPI Number : 1568284370
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN KONEZNY PHARMD
Provider Business Mailing Address
First Line : 3300 FREMONT AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55412-2405
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3300 FREMONT AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55412-2405
Country : US
Telephone Number : 612-588-9411
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2024
Last Update Date : 10/31/2024

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Directions to “ SUSAN KONEZNY PHARMD” Practice Location

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