Provider Demographics
NPI:1942494547
Name:CONNELLY, JOAN MARY (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:MARY
Last Name:CONNELLY
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Gender:F
Credentials:CRNP
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Mailing Address - Street 1:100 E PENN SQ
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3323
Mailing Address - Country:US
Mailing Address - Phone:267-425-9234
Mailing Address - Fax:267-425-9299
Practice Address - Street 1:3401 CIVIC CENTER BLVD
Practice Address - Street 2:CHILDREN'S HOSPITAL OF PHILADELPHIA - EMERGENCY MED
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4319
Practice Address - Country:US
Practice Address - Phone:215-590-1944
Practice Address - Fax:215-590-4454
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2013-05-22
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Provider Licenses
StateLicense IDTaxonomies
PASP008176363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics