Provider Demographics
NPI:1144610932
Name:CONNER, JOSHUA W (LPN)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:W
Last Name:CONNER
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3545 SHAWHAN RD
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:OH
Mailing Address - Zip Code:45152-9653
Mailing Address - Country:US
Mailing Address - Phone:513-470-3821
Mailing Address - Fax:
Practice Address - Street 1:3545 SHAWHAN RD
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:OH
Practice Address - Zip Code:45152-9653
Practice Address - Country:US
Practice Address - Phone:513-470-3821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-31
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH150735164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse