Provider Demographics
NPI:1801375456
Name:CONROW, KRISTINE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KRISTINE
Middle Name:
Last Name:CONROW
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 1:10 2ND ST SE UNIT 215
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-4477
Mailing Address - Country:US
Mailing Address - Phone:816-914-9862
Mailing Address - Fax:
Practice Address - Street 1:580 RICE ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55103-2148
Practice Address - Country:US
Practice Address - Phone:651-227-6551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN123951183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist