Doctor Name: | TONIA MICHELLE CONN |
NPI Number: | 1770665028 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | C.N.P. |
License Number: | NP07466 |
Business Practice Address: | 111 Vandament Way Mount Orab, OH - 451548395 |
Business Phone Number: | 9374446750 |
Business Fax Number: | 9374446751 |
Mailing Address: | 111 Vandament Way, MOUNT ORAB |
State: | OH |
Postal Code: | 451548395 |
Phone Number: | 9374446750 |
Fax Number: | 9374446751 |
NPI Enumeration Date: | 10/19/2006 |
NPI Last Update Date: | 09/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | NP07466 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |