Provider Demographics
NPI:1952849077
Name:GELINEAU, CONNIE (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:
Last Name:GELINEAU
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6020 W PARKER RD STE 270
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-0007
Mailing Address - Country:US
Mailing Address - Phone:972-378-4107
Mailing Address - Fax:855-675-9368
Practice Address - Street 1:6020 W PARKER RD STE 270
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-0007
Practice Address - Country:US
Practice Address - Phone:972-378-4107
Practice Address - Fax:855-675-9368
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-09
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00009070183500000X
NY63637183500000X
OK18154183500000X
IA23159183500000X
TX45214183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist