Provider Demographics
NPI:1740293828
Name:O'CONNOR, PATRICIA (APRN)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 PLEASANT ST
Mailing Address - Street 2:SUITE 6073
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-7539
Mailing Address - Country:US
Mailing Address - Phone:603-415-6685
Mailing Address - Fax:603-227-7191
Practice Address - Street 1:250 PLEASANT ST
Practice Address - Street 2:SUITE 6073
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-7539
Practice Address - Country:US
Practice Address - Phone:603-415-6685
Practice Address - Fax:603-227-7191
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001599363LF0000X
NH021703-23363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTS70807Medicare UPIN