Provider Demographics
NPI:1831325042
Name:CONNER, LINDA MARNELL (RN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MARNELL
Last Name:CONNER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 BOHANNON RD
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-2822
Mailing Address - Country:US
Mailing Address - Phone:404-314-9108
Mailing Address - Fax:770-306-1400
Practice Address - Street 1:142 BOHANNON RD
Practice Address - Street 2:
Practice Address - City:FAIRBURN
Practice Address - State:GA
Practice Address - Zip Code:30213-2822
Practice Address - Country:US
Practice Address - Phone:404-314-9108
Practice Address - Fax:770-306-1400
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN121751372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion