Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 086471-23 | NH |
N | 363LA2100X | Nurse Practitioner - Acute Care | RN2285154 | MA |
NPI | 1023559093 |
---|---|
Provider Name | Emmalie Bliss Connor |
First Address | Boston, MA 02241-2503 |
Second Address | Dover, NH 03820-2807 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2017 |
Last Update Date | 07/12/2021 |