Provider Demographics
NPI:1639508997
Name:CONNOR, ELIZABETH (ANP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:CONNOR
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-4256
Mailing Address - Country:US
Mailing Address - Phone:803-775-1001
Mailing Address - Fax:803-774-1012
Practice Address - Street 1:900 BOWMAN RD STE 301
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3233
Practice Address - Country:US
Practice Address - Phone:843-606-4005
Practice Address - Fax:843-606-4008
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN TP 18554363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health