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Individual

JEFFREY DANNER CONANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2298 SPRINGPORT RD, JACKSON, MI 49202-1475
(517) 784-3950
(571) 783-2728
Mailing address
5880 MCCRUM RD, JACKSON, MI 49201
(517) 879-9577

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0509 P
NH
363A00000X
Physician Assistant
5601005057
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00059932
BCBS OF VT
VT
05
0301819
VT
05
1011463
VT
05
30213617
NH
05
30332889
NH
05
30513983
NH
01
714276
MVP
NH
01
7459647
AETNA GROUP PROV NUMBER
NH
01
7460555
AETNA
NH
01
8000921
LADIES FIRST PROV NUMBER
VT
05
9000178
VT
01
RE8542
GROUP NHIC NUMBER
NH
Enumeration date
05/09/2006
Last updated
11/29/2007
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