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NPI Code Detail

MEDICARE: STEPHANIE ANN CONNOR NP

MEDICARE: STEPHANIE ANN CONNOR NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2100XAcute Care Nurse PractitionerAPRN02977RI
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN02977RI
3363LF0000XFamily Nurse PractitionerAPRN02977RI

General Provider Information

NPI Number : 1073251039
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE ANN CONNOR NP
Provider Business Mailing Address
First Line : 1524 ATWOOD AVE STE 220
Second Line :
City : JOHNSTON
State : RI
Zip : 02919-3288
Country : US
Telephone Number : 401-272-1900
Fax Number : 401-453-3049
Provider Business Practice Location Address
First Line : 1524 ATWOOD AVE STE 220
Second Line :
City : JOHNSTON
State : RI
Zip : 02919-3278
Country : US
Telephone Number : 401-272-1900
Fax Number : 401-453-3049
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2022
Last Update Date : 05/20/2022

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