Provider Demographics
NPI:1386055259
Name:CONNER, CHASTITY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHASTITY
Middle Name:
Last Name:CONNER
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 1:225 NORTH MAIN STREET
Mailing Address - Street 2:P O BOX 29
Mailing Address - City:RICH SQUARE
Mailing Address - State:NC
Mailing Address - Zip Code:27869
Mailing Address - Country:US
Mailing Address - Phone:252-862-0009
Mailing Address - Fax:
Practice Address - Street 1:700 CATHERINE CREEK RD S
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-3906
Practice Address - Country:US
Practice Address - Phone:252-862-0009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23951183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist