Provider Demographics
NPI:1043244528
Name:CONWAY, JEANNINE MELISSA (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:JEANNINE
Middle Name:MELISSA
Last Name:CONWAY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JEANNINE
Other - Middle Name:MELISSA
Other - Last Name:PLUHAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - Street 2:420 DELAWARE STREET SE, MMC 295
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-626-3004
Mailing Address - Fax:
Practice Address - Street 1:308 HARVARD STREET SE
Practice Address - Street 2:CLINIC 1A
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-626-3004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN116578-21835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy