Conner, Teresa A
Conner, Teresa A is an sole proprietor health care provider with primary practice located at 4122 Halifax Dr , Port Orange FL 32127-4539. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Conner, Teresa A can be contacted via phone (386) 237-4420.Contact Information
Primary practice address
4122 Halifax Dr
Port Orange FL 32127-4539
Phone: (386) 237-4420
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 754365 | Texas |
Profile Details
| NPI number | 1639325699 |
|---|---|
| LBN Legal business name | Conner, Teresa A |
| Credentials | Certified Registered Nurse Anesthetist (CRNA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 11th, 2008 |
| Last updated | Mar 23rd, 2017 - about 8 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 | 1639325699 | NPPES |
| Texas | Other | 8260UU | BCBS |
| Texas | MEDICAID | 02855577 | BCBS |
| Texas | MEDICAID | 209585301 | BCBS |
| Texas | MEDICAID | 209585302 | BCBS |
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