Provider Demographics
NPI:1710919204
Name:CONNOR, ERIN L (CRNA)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:L
Last Name:CONNOR
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32831 SERENE DR
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33982-9763
Mailing Address - Country:US
Mailing Address - Phone:941-585-3314
Mailing Address - Fax:
Practice Address - Street 1:32831 SERENE DR
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33982-9763
Practice Address - Country:US
Practice Address - Phone:941-585-3314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2333089367500000X
FL2797282367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL303673100Medicaid
G2838OtherBCBS OF FL
FL303673100Medicaid
FLG2838PMedicare PIN