Provider Demographics
NPI:1538453915
Name:MCCONNELL, CHRISTINA (PHARM D)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:MCCONNELL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 NW FEDERAL HWY
Mailing Address - Street 2:TARGET PHARMACY (T-0816)
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-9318
Mailing Address - Country:US
Mailing Address - Phone:772-692-8090
Mailing Address - Fax:772-692-8090
Practice Address - Street 1:2650 NW FEDERAL HWY
Practice Address - Street 2:TARGET PHARMACY (T-0816)
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-9318
Practice Address - Country:US
Practice Address - Phone:772-692-8090
Practice Address - Fax:772-692-8090
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40205183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist