Provider Demographics
NPI:1093192981
Name:CONNORS, BREANNE KELLY (CRNP)
Entity Type:Individual
Prefix:
First Name:BREANNE
Middle Name:KELLY
Last Name:CONNORS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:BREANNE
Other - Middle Name:KELLY
Other - Last Name:CONNORS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:8041 CASTLEHILL RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-7227
Mailing Address - Country:US
Mailing Address - Phone:205-765-5377
Mailing Address - Fax:
Practice Address - Street 1:817 PRINCETON AVENUE
Practice Address - Street 2:BUILDING 2, SUITE 108
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-3521
Practice Address - Country:US
Practice Address - Phone:205-781-1950
Practice Address - Fax:205-787-0057
Is Sole Proprietor?:No
Enumeration Date:2015-04-30
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-134460163W00000X, 363L00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner