Healthcare Provider Details

I. General information

NPI: 1265202071
Provider Name (Legal Business Name): ABIGAIL CONNOR CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2024
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2135 DANA AVE STE 410
CINCINNATI OH
45207-1327
US

IV. Provider business mailing address

3926 KILBOURNE AVE APT 2
CINCINNATI OH
45209-1817
US

V. Phone/Fax

Practice location:
  • Phone: 513-861-0222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0035593
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: