Individual
LISA MARIE CONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
18077 RIVER RD STE 104A, NOBLESVILLE, IN 46062-8311
(317) 674-0208
Mailing address
18077 RIVER RD STE 104A, NOBLESVILLE, IN 46062-8311
(317) 674-0208
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71003895A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201053310
—
IN
Enumeration date
03/01/2012
Last updated
03/29/2021
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