Provider Demographics
NPI:1023676657
Name:CONNER, NOLIE GREGORY (FNP-BC)
Entity type:Individual
Prefix:
First Name:NOLIE
Middle Name:GREGORY
Last Name:CONNER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 MAJOR HOLLAND RD
Mailing Address - Street 2:
Mailing Address - City:UNION HALL
Mailing Address - State:VA
Mailing Address - Zip Code:24176-2501
Mailing Address - Country:US
Mailing Address - Phone:540-493-3095
Mailing Address - Fax:
Practice Address - Street 1:447 MAJOR HOLLAND RD
Practice Address - Street 2:
Practice Address - City:UNION HALL
Practice Address - State:VA
Practice Address - Zip Code:24176-2501
Practice Address - Country:US
Practice Address - Phone:540-493-3095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001160463363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily