Individual
MS. LAURETTA ANNE CONNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
109 W 6TH ST, COOKEVILLE, TN 38501-1721
(931) 528-6945
(931) 372-2234
Mailing address
109 W 6TH ST, COOKEVILLE, TN 38501-1721
(931) 528-6945
(931) 372-2234
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
35068939
OH
207V00000X
Obstetrics & Gynecology Physician
Primary
MD29602
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3079525
BCBS
—
05
—
3818824
—
TN
01
—
5711580
CIGNA
—
Enumeration date
11/13/2006
Last updated
06/11/2013
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