Healthcare Provider Details

I. General information

NPI: 1154504256
Provider Name (Legal Business Name): JANE G CONNER MSN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2007
Last Update Date: 12/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1845 N FAIR OAKS AVE
PASADENA CA
91103-1620
US

IV. Provider business mailing address

3780 GREENHILL RD
PASADENA CA
91107-2230
US

V. Phone/Fax

Practice location:
  • Phone: 626-744-6125
  • Fax:
Mailing address:
  • Phone: 626-351-9372
  • Fax: 626-351-0308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberRN 129816
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: