MEDICARE: JULIE CONNELL 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
1	183500000X	Pharmacist	115359	MN

General Provider Information

NPI Number	:	1588252787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE CONNELL PHARMD

Provider Business Mailing Address
First Line	:	1810 MALVERN ST
Second Line	:
City	:	LAUDERDALE
State	:	MN
Zip	:	55113-5240
Country	:	US
Telephone Number	:	952-388-7953
Fax Number	:

Provider Business Practice Location Address
First Line	:	1810 MALVERN ST
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55113-5240
Country	:	US
Telephone Number	:	952-388-7953
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2021
Last Update Date	:	01/04/2021

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Directions to “ JULIE CONNELL PHARMD” Practice Location

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