Provider Demographics
NPI:1851940688
Name:MCCONNELL, KRISTINA (PHARMD)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:MCCONNELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:
Other - Last Name:DOZON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:5294 N ROCK SPRING ST
Mailing Address - Street 2:
Mailing Address - City:BEL AIRE
Mailing Address - State:KS
Mailing Address - Zip Code:67226-1120
Mailing Address - Country:US
Mailing Address - Phone:402-750-2791
Mailing Address - Fax:
Practice Address - Street 1:2740 N REGENCY PARK
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-4527
Practice Address - Country:US
Practice Address - Phone:402-750-2791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-16799183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist