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Individual
PATTI S. CONNOLLY
Active
Individual
PATTI S. CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA003385L
PA
363AM0700X
Medical Physician Assistant
MA003385L
PA
363AS0400X
Surgical Physician Assistant
MA003385L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03159201
BLUE CROSS
PA
01
—
970016803
RAILROAD MEDICARE
PA
Enumeration date
09/06/2005
Last updated
10/09/2025
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