Provider Demographics
NPI:1467645275
Name:MCCONNELL, BRETT PATRICK (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:PATRICK
Last Name:MCCONNELL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 S STORY ST
Mailing Address - Street 2:C
Mailing Address - City:BOONE
Mailing Address - State:IA
Mailing Address - Zip Code:50036-4739
Mailing Address - Country:US
Mailing Address - Phone:515-432-3460
Mailing Address - Fax:515-432-7169
Practice Address - Street 1:120 S STORY ST
Practice Address - Street 2:C
Practice Address - City:BOONE
Practice Address - State:IA
Practice Address - Zip Code:50036-4739
Practice Address - Country:US
Practice Address - Phone:515-432-3460
Practice Address - Fax:515-432-7169
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20555183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist