Connor Michael Allen
Individual provider Active NPI Pharmacist · Kearney, MO
NPI 1235747601 · NPPES record last updated Jul 21, 2020
Key facts
- NPI
- 1235747601
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 2019037447 (MO)
- Practice address
- 17002 NE 121St Ter
Kearney, MO 64060-7449 - Phone
- (816) 810-2590
- NPI assigned
- Jul 21, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019037447 | MO | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2019037447 | MO | Yes |
Addresses
Primary practice location
17002 NE 121St Ter
Kearney, MO 64060-7449
Mailing address
17002 NE 121St Ter
Kearney, MO 64060-7449
Phone (816) 810-2590
Other providers in Kearney, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.