Provider Demographics
NPI:1184407165
Name:DODSON-CONNER, KRISTI RENE (FNP-BC)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:RENE
Last Name:DODSON-CONNER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:RENE
Other - Last Name:DODSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:6300 SEAWALL BLVD # 9201
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77551-2219
Mailing Address - Country:US
Mailing Address - Phone:254-248-4185
Mailing Address - Fax:
Practice Address - Street 1:4002 BURKE RD # 100
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-3451
Practice Address - Country:US
Practice Address - Phone:281-741-2982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX984604163WG0000X
TX1135857363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice