Individual provider · NPI-1

Shannon Kristi Connor, OD

Optometrist · Tempe, AZ

NPI number1407602634
StatusActive
Last updated in NPPESJul 3, 2024

Details

NPI
1407602634
Entity type
Individual (NPI-1)
Name
Shannon Kristi Connor
Credential
OD
Sex
Female
Sole proprietor
No
Enumeration date
Apr 29, 2024
Certification date
May 27, 2024
Last updated
Jul 3, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X OptometristOPT-002791AZYes

Practice location

2020 E Rio Salado Pkwy # 101
Tempe, AZ 85288-3042

Phone 480-967-0563 · Fax 480-967-0563

Mailing address

7700 W Arrowhead Towne Ctr Ste 2130
Glendale, AZ 85308-0929

Phone 602-571-8669

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