Provider Demographics
NPI:1992558993
Name:CONNOR, CHRISTOPHER JOHN (FNP-C)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:CONNOR
Suffix:
Gender:M
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 1:93 CAMPUS AVE
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-6030
Mailing Address - Country:US
Mailing Address - Phone:207-777-8100
Mailing Address - Fax:
Practice Address - Street 1:1230 MAINE ST
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:ME
Practice Address - Zip Code:04274-7325
Practice Address - Country:US
Practice Address - Phone:207-998-4483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP241121363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care