Provider Demographics
NPI:1467758649
Name:ANDREA J CONNORS, LLC
Entity Type:Organization
Organization Name:ANDREA J CONNORS, LLC
Other - Org Name:BELLECARE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:CONNORS
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:734-699-5400
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 1:25 OWEN ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48111-2921
Practice Address - Country:US
Practice Address - Phone:734-699-5400
Practice Address - Fax:734-699-5455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-04
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty