=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669093050
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEALTH CONNECTIONS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/27/2020
-----------------------------------------------------
Last Update Date | 04/27/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 475 W GOVERNOR RD STE 7
-----------------------------------------------------
City | HERSHEY
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17033-2217
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-707-5400
-----------------------------------------------------
Fax | 717-707-5339
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 475 W GOVERNOR RD STE 7
-----------------------------------------------------
City | HERSHEY
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17033-2217
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-707-5400
-----------------------------------------------------
Fax | 717-707-5339
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | LUNA METAYER BELIZAIRE
-----------------------------------------------------
Credential | CRNP
-----------------------------------------------------
Telephone | 717-304-7036
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------