Conner, Mary Susan
Conner, Mary Susan is an individual health care provider with primary practice located at 4331 S Fremont Ave , Springfield MO 65804-7328. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Conner, Mary Susan can be contacted via phone (417) 820-5000.Contact Information
Primary practice address
4331 S Fremont Ave
Springfield MO 65804-7328
Phone: (417) 820-5000
Fax: (417) 820-5025
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 058838 | Missouri |
Profile Details
| NPI number | 1265572176 |
|---|---|
| LBN Legal business name | Conner, Mary Susan |
| Credentials | Certified Pediatric Nurse Practitioner (CPNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 8th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1265572176 | NPPES |
| Arkansas | Other | 83416 | ARK BLUE SHIELD |
| Arkansas | Other | 205822 | ARK BLUE SHIELD |
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