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General NPI Number Information
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NPI Number | 1124242318
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Entity Type | Individual
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Provider Name | KELLY ANN O'CONNOR ARNP
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Gender | Female
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 04/08/2009
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Provider Practice Location Address
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Address Line | 249 MAITLAND AVE SUITE 1020
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-4906
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Country | US
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Telephone | 407-260-9990
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Fax | 407-260-9951
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Provider Business Mailing Address
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Address Line | 249 MAITLAND AVE SUITE 1020
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-4906
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Country | US
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Telephone | 407-260-9990
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Fax | 407-260-9951
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP3030752
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License Number State | FL
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