Individual
CONNIE R AVERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
16 PIN OAK LN, TROY, PA 16947-8672
(607) 738-7201
Mailing address
16 PIN OAK LN, TROY, PA 16947-8672
(607) 738-7201
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
571452-1
NY
163W00000X
Registered Nurse
RN566546
PA
Other
Enumeration date
09/28/2015
Last updated
09/28/2015
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