Individual
MARY SUSAN CONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
058838
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
205822
MO BLUE SHIELD
MO
01
—
83416
ARK BLUE SHIELD
AR
Enumeration date
02/08/2007
Last updated
07/08/2007
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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