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General NPI Number Information
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NPI Number | 1467758649
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Entity Type | Organization
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Legal Business Name | ANDREA J CONNORS, LLC
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Dates
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Enumeration Date | 02/04/2011
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Last Update Date | 10/31/2014
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Provider Practice Location Address
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Address Line | 25 OWEN ST
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City | BELLEVILLE
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State | MI
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Zip | 48111-2921
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Country | US
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Telephone | 734-699-5400
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Fax | 734-699-5455
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Provider Business Mailing Address
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Address Line | 25 OWEN ST
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City | BELLEVILLE
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State | MI
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Zip | 48111-2921
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Country | US
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Telephone | 734-699-5400
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Fax | 734-699-5455
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Authorized Official
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Title or Position | OWNER
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Name | MS. ANDREA JOY CONNORS
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Credential | NP-C
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Telephone | 734-699-5400
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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 |
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License Number State |
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