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Individual

ANDREA KRISTIN CONNELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, MSN, CPNP-AC

Contact information

Practice address
4650 W SUNSET BLVD, MAIL STOP 66, LOS ANGELES, CA 90027-6062
(323) 361-4148
(323) 361-3668
Mailing address
3701 WILSHIRE BLVD STE 600, LOS ANGELES, CA 90010-2814
(323) 361-3550
(323) 361-8052

Taxonomy

Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
95003749
CA
363LP0200X
Pediatric Nurse Practitioner
Primary
95003749
CA
363LP0222X
Critical Care Pediatric Nurse Practitioner
95003749
CA

Other

Enumeration date
03/07/2016
Last updated
12/06/2017
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