Provider Demographics
NPI:1225073844
Name:MAY, CONNIE MARIE (ARNP)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:MARIE
Last Name:MAY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1164 45TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-5248
Mailing Address - Country:US
Mailing Address - Phone:727-430-0156
Mailing Address - Fax:
Practice Address - Street 1:237 PAYNE PKWY
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-7018
Practice Address - Country:US
Practice Address - Phone:941-893-2556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20423A363LF0000X
FLARNP3286162363L00000X
NYF341491-01363LF0000X
CT11192363LF0000X
KY3011083363LF0000X
GA261092363LF0000X
VT101.0137211363LF0000X
MI4704327045363LF0000X
NC501005363LF0000X
MDAC003112363LF0000X
VA0024174251363LF0000X
TN0000022138363LF0000X
ME241444363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0000022138OtherAPRN
MI4704327045OtherAPRN
ME241444OtherAPRN
FL306001200Medicaid
NYF341491-01OtherAPRN
CT11192OtherAPRN
GA261092OtherAPRN