Provider Demographics
NPI:1851787972
Name:BIRKEL, CONNOR LANSING (PHARMD)
Entity Type:Individual
Prefix:
First Name:CONNOR
Middle Name:LANSING
Last Name:BIRKEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 W HIGHWAY 61 STE A
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-1957
Mailing Address - Country:US
Mailing Address - Phone:507-615-0636
Mailing Address - Fax:507-615-0616
Practice Address - Street 1:1122 W HIGHWAY 61 STE A
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-1957
Practice Address - Country:US
Practice Address - Phone:507-615-0636
Practice Address - Fax:507-615-0616
Is Sole Proprietor?:No
Enumeration Date:2015-04-15
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17967-40183500000X
MN124390183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist