Provider Demographics
NPI:1487656187
Name:CONDREN, MICHELLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:CONDREN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:MICHELLE
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7910 N 192ND EAST AVE
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-8218
Mailing Address - Country:US
Mailing Address - Phone:918-272-1015
Mailing Address - Fax:
Practice Address - Street 1:1600 S COULTER ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1710
Practice Address - Country:US
Practice Address - Phone:806-356-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK123421835P0018X
TX379711835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist