Provider Demographics
NPI:1750764734
Name:CONNOLLY, REBECCA ANNE (ARNP)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:ANNE
Last Name:CONNOLLY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 LAKE WORTH RD
Mailing Address - Street 2:SUITE 100W
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33467
Mailing Address - Country:US
Mailing Address - Phone:561-965-9559
Mailing Address - Fax:561-964-9904
Practice Address - Street 1:6801 LAKE WORTH RD
Practice Address - Street 2:SUITE 100W
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33467
Practice Address - Country:US
Practice Address - Phone:561-965-9559
Practice Address - Fax:561-964-9904
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2022-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9303849363LF0000X
FLAPRN9303849363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily