Provider Demographics
NPI:1043260680
Name:CONNER, ANITA G (NP)
Entity Type:Individual
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First Name:ANITA
Middle Name:G
Last Name:CONNER
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Gender:F
Credentials:NP
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Mailing Address - Street 1:1201 BROAD ROCK BLVD
Mailing Address - Street 2:MCGURIE VA MEDICAL CTR (111K) HEM/ONCOLOGY SECTION
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23249-0001
Mailing Address - Country:US
Mailing Address - Phone:804-675-5446
Mailing Address - Fax:804-675-5447
Practice Address - Street 1:1201 BROAD ROCK BLVD
Practice Address - Street 2:MCGURIE VA MEDICAL CTR (111K) HEM/ONCOLOGY SECTION
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23249-0001
Practice Address - Country:US
Practice Address - Phone:804-675-5446
Practice Address - Fax:804-675-5447
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2008-02-08
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Provider Licenses
StateLicense IDTaxonomies
VA0024086948363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP58002Medicare UPIN
VA012329V43Medicare ID - Type UnspecifiedMEDICARE ID