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Individual
MRS. GREER G CONNELLY
Active
Individual
MRS. GREER G CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
004620
GA
367H00000X
Anesthesiologist Assistant
Primary
004620
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
679028104F
—
GA
Enumeration date
07/17/2006
Last updated
10/01/2010
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