Provider Demographics
NPI:1992944565
Name:CONNER, KATHE ANN (RN/FNP BC)
Entity type:Individual
Prefix:MRS
First Name:KATHE
Middle Name:ANN
Last Name:CONNER
Suffix:
Gender:F
Credentials:RN/FNP BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1901 JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76909-0001
Mailing Address - Country:US
Mailing Address - Phone:325-942-2171
Mailing Address - Fax:325-942-2133
Practice Address - Street 1:1901 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76909-0001
Practice Address - Country:US
Practice Address - Phone:325-942-2171
Practice Address - Fax:325-942-2133
Is Sole Proprietor?:No
Enumeration Date:2009-02-05
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX244559363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0278285OtherANCC