Provider Demographics
NPI:1043299191
Name:NEAL, CONNIE ANN (RN, MSN,FNP-C)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:ANN
Last Name:NEAL
Suffix:
Gender:F
Credentials:RN, MSN,FNP-C
Other - Prefix:
Other - First Name:CONNIE
Other - Middle Name:ANN
Other - Last Name:WINGROVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:459 N GILBERT RD
Mailing Address - Street 2:SUITE D-160
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-4591
Mailing Address - Country:US
Mailing Address - Phone:480-539-8680
Mailing Address - Fax:480-539-1763
Practice Address - Street 1:459 N GILBERT RD
Practice Address - Street 2:SUITE D-160
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-4591
Practice Address - Country:US
Practice Address - Phone:480-539-8680
Practice Address - Fax:480-539-1763
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN071893363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily