Provider Demographics
NPI:1982176301
Name:CONN, JONELL (FNP)
Entity Type:Individual
Prefix:MS
First Name:JONELL
Middle Name:
Last Name:CONN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 E CORONADO RD STE 201
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1583
Mailing Address - Country:US
Mailing Address - Phone:480-712-4600
Mailing Address - Fax:
Practice Address - Street 1:337 E CORONADO RD STE 201
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-1583
Practice Address - Country:US
Practice Address - Phone:480-712-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-24
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAPRN220410363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAPRN220410OtherAZ STATE BOARD OF NURSING