Provider Demographics
NPI:1710296116
Name:CONNOLLY, RONALD C (FNP)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:C
Last Name:CONNOLLY
Suffix:
Gender:M
Credentials:FNP
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Mailing Address - Street 1:1776 YGNACIO VALLEY RD
Mailing Address - Street 2:SUITE #106
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3190
Mailing Address - Country:US
Mailing Address - Phone:925-974-7000
Mailing Address - Fax:925-974-7003
Practice Address - Street 1:1776 YGNACIO VALLEY RD
Practice Address - Street 2:SUITE #106
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3190
Practice Address - Country:US
Practice Address - Phone:925-974-7000
Practice Address - Fax:925-974-7003
Is Sole Proprietor?:No
Enumeration Date:2010-10-02
Last Update Date:2010-10-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA732729163W00000X
CA19644363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse