Provider Demographics
NPI:1306891023
Name:CONN, CHRISTIE DAWN (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:DAWN
Last Name:CONN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:DAWN
Other - Last Name:HAMPTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:333 BEACON HILL RD STE 201
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351-6182
Mailing Address - Country:US
Mailing Address - Phone:606-780-0444
Mailing Address - Fax:606-784-2344
Practice Address - Street 1:2300 KY 801 NORTH
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351
Practice Address - Country:US
Practice Address - Phone:606-548-5550
Practice Address - Fax:833-471-4492
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA937207R00000X, 363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine