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Individual

MRS. MARY KRISTEN JO CONNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1025 NEW MOODY LN, LA GRANGE, KY 40031-9154
(502) 222-5388
Mailing address
1811 CHERRY GLEN DR, LA GRANGE, KY 40031-6968
(502) 741-2169

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4033989
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4033989
KBN LICENSE NUMBER
KY
Enumeration date
02/24/2025
Last updated
02/24/2025
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