Provider Demographics
NPI:1124212113
Name:CONNORS, ANDREA JOY (DNP-C)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:JOY
Last Name:CONNORS
Suffix:
Gender:F
Credentials:DNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:25 OWEN ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48111-2921
Mailing Address - Country:US
Mailing Address - Phone:734-699-5400
Mailing Address - Fax:734-699-5455
Practice Address - Street 1:10280 BEMIS RD
Practice Address - Street 2:
Practice Address - City:WILLIS
Practice Address - State:MI
Practice Address - Zip Code:48191-9742
Practice Address - Country:US
Practice Address - Phone:734-699-5400
Practice Address - Fax:734-699-5455
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-01
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704239544363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health