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General NPI Number Information
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NPI Number | 1316752397
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Entity Type | Individual
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Provider Name | ALEXANDER CONNOR RN
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Gender | Male
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Dates
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Enumeration Date | 02/08/2025
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Last Update Date | 02/08/2025
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Provider Practice Location Address
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Address Line | 6009 SW WALNUT CV
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City | TRIMBLE
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State | MO
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Zip | 64492-8124
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Country | US
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Telephone | 816-519-0594
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Fax |
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Provider Business Mailing Address
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Address Line | 6009 SW WALNUT CV
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City | TRIMBLE
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State | MO
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Zip | 64492-8124
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Country | US
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Telephone | 816-519-0594
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Fax |
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 2023025669
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License Number State | MO
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