Individual
PEGE CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
317 IRENE AVE., IRONTON, MN 56455
(218) 546-6242
(218) 772-0142
Mailing address
317 IRENE AVE. P.O. BOX 1, IRONTON, MN 56455
(218) 546-6242
(218) 772-0142
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
R-107553-9
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669628921
—
MN
Enumeration date
10/11/2017
Last updated
10/11/2017
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