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General NPI Number Information
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NPI Number | 1265931851
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Entity Type | Individual
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Provider Name | SANDRA J CONN APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/08/2018
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 125 S MAIN CROSS ST
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City | LOUISA
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State | KY
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Zip | 41230-1065
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Country | US
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Telephone | 606-638-0938
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Fax | 859-813-5394
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Provider Business Mailing Address
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Address Line | 125 S MAIN CROSS ST
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City | LOUISA
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State | KY
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Zip | 41230-1065
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Country | US
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Telephone | 606-638-0938
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Fax | 859-813-5394
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F10170103
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3011776
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License Number State | KY
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