Provider Demographics
NPI:1346688306
Name:CONNERS, LORI LYNN (MS, RN, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:LYNN
Last Name:CONNERS
Suffix:
Gender:F
Credentials:MS, RN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 W JOHN CARPENTER FWY STE 420
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-2014
Mailing Address - Country:US
Mailing Address - Phone:972-957-3000
Mailing Address - Fax:
Practice Address - Street 1:1111 W AIRPORT FWY STE 143
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-6204
Practice Address - Country:US
Practice Address - Phone:469-488-4500
Practice Address - Fax:469-488-4501
Is Sole Proprietor?:No
Enumeration Date:2013-06-11
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201401242NP-PP363LP0200X
TXAP123972363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500669246Medicaid
OR500669246Medicaid