Provider Demographics
NPI:1053045146
Name:CONNER, TASHA L
Entity Type:Individual
Prefix:MS
First Name:TASHA
Middle Name:L
Last Name:CONNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 126
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39533-0126
Mailing Address - Country:US
Mailing Address - Phone:228-328-5914
Mailing Address - Fax:
Practice Address - Street 1:264 STRANGI AVE
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39530-2531
Practice Address - Country:US
Practice Address - Phone:228-328-5914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide