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CONNER PETERSON PHARMD
NPI 1104379064
Pharmacist in Boise, ID

Active since July 27, 2016
455 S BROADWAY AVE, BOISE, ID 83702(208) 331-4187 Get Directions Write a Review

NPPES record last updated: July 27, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Conner Peterson Pharmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CONNER PETERSON PHARMD (NPI 1104379064) is an individual pharmacist in Boise, Idaho, licensed in Idaho (P7602) and active in the NPI registry since July 2016.

NPPES Registry Identity

NPI1104379064
Entity TypeIndividualMale
Primary Taxonomy183500000X
Provider Legal NameCONNER PETERSONCredential: PHARMD
Location Address455 S BROADWAY AVEBoise, ID 83702-7643
Mailing Address455 S Broadway AveBoise, ID 83702-7643 · (208) 331-4187
Phone(208) 331-4187
Sole ProprietorYes
Enumeration DateJuly 27, 2016
✔ NPI 1104379064 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License✔ Licensed in ID · P7602
Definition
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
455 S BROADWAY AVE, Boise, ID 83702
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Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JILU DANIEL VARUGHESE
Pharmacist
455 S BROADWAY AVE
BOISE, ID 83702
Ada County (208) 331-4187
WALGREEN CO
Pharmacy
455 S BROADWAY AVE
BOISE, ID 83702
Ada County (208) 331-4187
MS. SZE WAN CHAN RPH
Pharmacist
455 S BROADWAY AVE
BOISE, ID 83702
Ada County (208) 331-4187
SISI FREELEY
Pharmacist
455 S BROADWAY AVE
BOISE, ID 83702
Ada County (208) 331-4187
JENNA BRETT DANSIE
Pharmacy Technician
455 S BROADWAY AVE
BOISE, ID 83702
Ada County (208) 331-4187
RADHIKA UMESH NARSINGHANI
Pharmacist
455 S BROADWAY AVE
BOISE, ID 83702
Ada County (208) 331-4187

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Conner Peterson's NPI number?

The NPI number for Conner Peterson is 1104379064. It was assigned to this individual provider in the NPPES registry on July 27, 2016.

Where is Conner Peterson located?

Conner Peterson practices at 455 S Broadway Ave, Boise, ID 83702. The listed phone number is (208) 331-4187.

What is Conner Peterson's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Conner Peterson was last updated on July 27, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.