Provider Demographics
NPI:1154901700
Name:CONNER, ABIGAIL (CRNA)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:CONNER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:99 E RIVER DR FL 5
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-7301
Mailing Address - Country:US
Mailing Address - Phone:860-282-4104
Mailing Address - Fax:
Practice Address - Street 1:326 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2740
Practice Address - Country:US
Practice Address - Phone:203-929-7353
Practice Address - Fax:203-929-0756
Is Sole Proprietor?:No
Enumeration Date:2021-04-08
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11026394367500000X
CT12029367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9532080OtherRN