Provider Demographics
NPI:1346463064
Name:CONNOR, DELLA ELAINE (FNP)
Entity Type:Individual
Prefix:
First Name:DELLA
Middle Name:ELAINE
Last Name:CONNOR
Suffix:
Gender:F
Credentials:FNP
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 150408
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75915-0408
Mailing Address - Country:US
Mailing Address - Phone:936-634-2227
Mailing Address - Fax:
Practice Address - Street 1:1111 W FRANK AVE STE 303
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3330
Practice Address - Country:US
Practice Address - Phone:936-634-2227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX654634163W00000X
TX363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP99940Medicare UPIN