Individual
MARY VICTORIA CONNERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
630 BROADWAY ST, MADISON, IN 47250
(812) 801-0338
(812) 801-0777
Mailing address
PO BOX 3395, EVANSVILLE, IN 47732-3395
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001571A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200137600
—
IN
01
—
383332
ANTHEM
IN
01
—
7254710
AETNA
IN
05
—
78014313
—
KY
Enumeration date
10/20/2005
Last updated
02/20/2019
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