Connelly, Carol
Connelly, Carol is an individual health care provider with primary practice located at 407 S Schwartz Ave Ste 102, Farmington NM 87401-5925. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Connelly, Carol can be contacted via phone (505) 609-6700.Contact Information
Primary practice address
407 S Schwartz Ave Ste 102
Farmington NM 87401-5925
Phone: (505) 609-6700
Fax: (505) 609-6701
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | R39967 | New Mexico |
Profile Details
| NPI number | 1609969245 |
|---|---|
| LBN Legal business name | Connelly, Carol |
| Credentials | Certified Nurse Practitioner (CNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 2nd, 2006 |
| Last updated | Apr 10th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609969245 | NPPES |
| New Mexico | MEDICAID | 000Z0447 |
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