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General NPI Number Information
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NPI Number | 1528009784
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Entity Type | Individual
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Provider Name | SUSANN CONNER O'CONNOR CRNP
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Gender | Female
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 10/24/2017
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Provider Practice Location Address
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Address Line | 6701 AIRPORT BLVD SUITE A-101
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City | MOBILE
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State | AL
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Zip | 36608-6705
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Country | US
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Telephone | 251-633-8880
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Fax | 251-634-4507
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Provider Business Mailing Address
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Address Line | 6701 AIRPORT BLVD STE A101
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City | MOBILE
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State | AL
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Zip | 36608-6767
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Country | US
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Telephone | 251-633-8880
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Fax | 251-378-6222
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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 | 1077257
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License Number State | AL
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