Provider Demographics
NPI:1255145348
Name:WESTERMAN, CONOR (PMHNP)
Entity type:Individual
Prefix:
First Name:CONOR
Middle Name:
Last Name:WESTERMAN
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16490 W LARIAT LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85387-6817
Mailing Address - Country:US
Mailing Address - Phone:623-204-5124
Mailing Address - Fax:
Practice Address - Street 1:1655 N TEGNER ST
Practice Address - Street 2:
Practice Address - City:WICKENBURG
Practice Address - State:AZ
Practice Address - Zip Code:85390-1461
Practice Address - Country:US
Practice Address - Phone:623-204-5124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ227933363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health