Connolly, Marilyn Gray

Connolly, Marilyn Gray is an individual health care provider with primary practice located at 151 Southhall Ln Ste 300 , Maitland FL 32751-7172. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Connolly, Marilyn Gray can be contacted via phone (407) 917-7293.

Contact Information

Primary practice address
151 Southhall Ln Ste 300 Maitland FL 32751-7172
Phone: (407) 917-7293
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X APRN11011911 Florida

Profile Details

NPI number 1417551268
LBN Legal business name Connolly, Marilyn Gray
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 23rd, 2020
Last updated Jun 17th, 2024 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417551268 NPPES
Florida Other UDET1 BLUE CROSS BLUE SHIELD
Florida MEDICAID 120071900 BLUE CROSS BLUE SHIELD

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