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Individual

ELIZABETH ERIN CONN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1541 FLORIDA AVE STE 200, MODESTO, CA 95350-4438
(209) 577-3388
Mailing address
PO BOX 976, 23289 JOAQUIN GULLY ROAD, TWAIN HARTE, CA 95383
(949) 547-8718

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
23261
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
23261
CA NURSE PRACTITIONER FURNISHING NUMBER
CA
01
680454
CA RN NUMBER
CA
Enumeration date
07/19/2013
Last updated
02/13/2020
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