Provider Demographics
NPI:1780361485
Name:CONNER CARING MINDZ OF PSYCHIATRY
Entity type:Organization
Organization Name:CONNER CARING MINDZ OF PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:LATRICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:732-535-7474
Mailing Address - Street 1:1118 EASTON AVE APT C
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1639
Mailing Address - Country:US
Mailing Address - Phone:732-535-7474
Mailing Address - Fax:
Practice Address - Street 1:1118 EASTON AVE APT C
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1639
Practice Address - Country:US
Practice Address - Phone:732-535-7474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty