Provider Demographics
NPI:1255913877
Name:CONNOR, BRYNN KIERAN (PA-C)
Entity type:Individual
Prefix:
First Name:BRYNN
Middle Name:KIERAN
Last Name:CONNOR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 BENTLEY DR
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-1350
Mailing Address - Country:US
Mailing Address - Phone:267-885-5454
Mailing Address - Fax:
Practice Address - Street 1:225 NEWTOWN RD
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-5221
Practice Address - Country:US
Practice Address - Phone:215-441-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-23
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA062199363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant