Provider Demographics
NPI:1033592944
Name:CONNIE LYNN EARLY
Entity Type:Organization
Organization Name:CONNIE LYNN EARLY
Other - Org Name:CNA TRANSPORTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:EARLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-645-6066
Mailing Address - Street 1:P.O. BOX 627
Mailing Address - Street 2:
Mailing Address - City:BYRON
Mailing Address - State:IL
Mailing Address - Zip Code:61010
Mailing Address - Country:US
Mailing Address - Phone:815-645-6066
Mailing Address - Fax:815-645-6066
Practice Address - Street 1:125 PRARIE MOON
Practice Address - Street 2:
Practice Address - City:DAVIS JUNCTION
Practice Address - State:IL
Practice Address - Zip Code:61020
Practice Address - Country:US
Practice Address - Phone:815-645-6066
Practice Address - Fax:815-645-6066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)