Provider Demographics
NPI:1386995512
Name:CONNOLLY, NORAH P (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:NORAH
Middle Name:P
Last Name:CONNOLLY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02302-3308
Mailing Address - Country:US
Mailing Address - Phone:508-941-7355
Mailing Address - Fax:508-941-6206
Practice Address - Street 1:680 CENTRE STREET
Practice Address - Street 2:SIGNATURE HEALTHCARE BROCKTON HOSPITAL
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-3395
Practice Address - Country:US
Practice Address - Phone:508-941-7355
Practice Address - Fax:508-941-6206
Is Sole Proprietor?:No
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA127423364SP2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP2800XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPerioperative