Provider Demographics
NPI:1124263496
Name:CONNER, DONALD JOHN JR (ARNP)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:JOHN
Last Name:CONNER
Suffix:JR
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 NW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34475-6234
Mailing Address - Country:US
Mailing Address - Phone:352-237-5400
Mailing Address - Fax:866-423-8644
Practice Address - Street 1:2650 NW 2ND ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34475-6234
Practice Address - Country:US
Practice Address - Phone:352-237-5400
Practice Address - Fax:866-423-8644
Is Sole Proprietor?:No
Enumeration Date:2008-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2743282363LP0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL306131100Medicaid