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NPI Code Detail

MEDICARE: MS. ELIZABETH C CONNER NP, RN

MEDICARE: MS. ELIZABETH C CONNER NP, RN
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
1363LP0200XPediatric Nurse Practitioner201912843MA
2163WC1500XCommunity Health Registered NurseRN200984MA

General Provider Information

NPI Number : 1194363267
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIZABETH C CONNER NP, RN
Provider Business Mailing Address
First Line : 36 OLD SUDBURY RD
Second Line :
City : LINCOLN
State : MA
Zip : 01773-4805
Country : US
Telephone Number : 197-387-5811
Fax Number :
Provider Business Practice Location Address
First Line : 126 PHOENIX AVE
Second Line :
City : LOWELL
State : MA
Zip : 01852-4991
Country : US
Telephone Number : 978-453-8331
Fax Number : 978-453-9254
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2019
Last Update Date : 12/19/2019

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