Doctor Name: | COURTNEY TAYLOR CONNOR |
NPI Number: | 1174978118 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | 9246541 |
Business Practice Address: | 651 Grand Panama Blvd Suite 102 Panama City Beach, FL - 324073458 |
Business Phone Number: | 8502330264 |
Business Fax Number: | 8502333113 |
Mailing Address: | 651 Grand Panama Blvd, Suite 102 PANAMA CITY BEACH |
State: | FL |
Postal Code: | 324073458 |
Phone Number: | 8502330264 |
Fax Number: | 8502333113 |
NPI Enumeration Date: | 04/27/2016 |
NPI Last Update Date: | 04/27/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 9246541 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |