Provider Demographics
NPI:1912106907
Name:CONNER, LYNDA MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:LYNDA
Middle Name:MARIE
Last Name:CONNER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N EDDY ST
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-4558
Mailing Address - Country:US
Mailing Address - Phone:308-384-6922
Mailing Address - Fax:308-384-7824
Practice Address - Street 1:3825 MEADOW RD
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-1579
Practice Address - Country:US
Practice Address - Phone:574-850-6478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001660152W00000X
IN18003495A152W00000X
NE1427152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist