Provider Demographics
NPI:1225585375
Name:CONNER, KELLI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KELLI
Middle Name:
Last Name:CONNER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 NORTON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-3214
Mailing Address - Country:US
Mailing Address - Phone:614-699-5530
Mailing Address - Fax:614-699-5531
Practice Address - Street 1:620 NORTON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-3214
Practice Address - Country:US
Practice Address - Phone:614-699-5530
Practice Address - Fax:614-699-5531
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051299494183500000X, 1835P0018X
OH032366461835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist