Provider Demographics
NPI:1124017801
Name:CONNOR, JOYCE M (CRNA)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:M
Last Name:CONNOR
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2653 STICKNEY POINT RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-6019
Mailing Address - Country:US
Mailing Address - Phone:941-342-8200
Mailing Address - Fax:941-342-8201
Practice Address - Street 1:2653 STICKNEY POINT RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-6019
Practice Address - Country:US
Practice Address - Phone:941-342-8200
Practice Address - Fax:941-342-8201
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2983092367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL301537800Medicaid
FLG1983OtherBLUE CROSS BLUE SHIELD
FLG1983ZMedicare ID - Type Unspecified