Doctor Name: | JAMES CONDON |
NPI Number: | 1023482619 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CRNP |
License Number: | SP015680 |
Business Practice Address: | 4372 Route 6 Kane, PA - 167353060 |
Business Phone Number: | 8148378585 |
Business Fax Number: | |
Mailing Address: | 595 N Michael St, SAINT MARYS |
State: | PA |
Postal Code: | 158571155 |
Phone Number: | 8147818473 |
Fax Number: | |
NPI Enumeration Date: | 11/19/2015 |
NPI Last Update Date: | 11/19/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | SP015680 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |