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NPI Code Detail

MEDICARE: MICHELLE L. CONNORS PA

MEDICARE: MICHELLE L. CONNORS PA
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
1363A00000XPhysician Assistant840MA

General Provider Information

NPI Number : 1225015167
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE L. CONNORS PA
Provider Business Mailing Address
First Line : 28 RIVERSIDE DR
Second Line :
City : PEMBROKE
State : MA
Zip : 02359-1937
Country : US
Telephone Number : 781-826-8065
Fax Number : 781-826-8043
Provider Business Practice Location Address
First Line : 28 RIVERSIDE DR
Second Line :
City : PEMBROKE
State : MA
Zip : 02359-1937
Country : US
Telephone Number : 781-826-8065
Fax Number : 781-826-8043
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2005
Last Update Date : 06/19/2019

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Directions to “ MICHELLE L. CONNORS PA” Practice Location

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