Basic Information
| Provider Information | |||||||||
| NPI: | 1093198525 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CONNERS | ||||||||
| FirstName: | AMY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 NEW SALEM RD STE 116 | ||||||||
| Address2: | |||||||||
| City: | UNIONTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 154018936 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7244370729 | ||||||||
| FaxNumber: | 7244372761 | ||||||||
| Practice Location | |||||||||
| Address1: | 125 CHAFFEE ST | ||||||||
| Address2: | |||||||||
| City: | UNIONTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 154014605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7244370729 | ||||||||
| FaxNumber: | 7244372761 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2015 | ||||||||
| LastUpdateDate: | 07/01/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0807X | RN635504 | PA | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Child & Adolescent |
No ID Information.