MEDICARE: MS. SANDRA LYNN CONNOR RN FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	581938	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003811597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SANDRA LYNN CONNOR RN FNP

Provider Business Mailing Address
First Line	:	1635 W DIVISION ST
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-3810
Country	:	US
Telephone Number	:	817-274-0097
Fax Number	:	817-274-0327

Provider Business Practice Location Address
First Line	:	1635 W DIVISION ST
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-3810
Country	:	US
Telephone Number	:	817-274-0097
Fax Number	:	817-274-0327

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	12/04/2025

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