MEDICARE: MS. AMY BETH CONNOR OTR/L

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	225X00000X	Occupational Therapist	5387	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1382K	OTHER	NC	BC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366403651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AMY BETH CONNOR OTR/L

Provider Business Mailing Address
First Line	:	PO BOX 92
Second Line	:
City	:	BRIDGETON
State	:	NC
Zip	:	28519-0092
Country	:	US
Telephone Number	:	252-497-5241
Fax Number	:	252-672-9201

Provider Business Practice Location Address
First Line	:	2619 TRENT RD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-2025
Country	:	US
Telephone Number	:	252-497-5241
Fax Number	:

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

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	08/18/2024

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