Basic Information
Provider Information
NPI: 1659668028
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CONNER
FirstName: WAYMEE
MiddleName: LWIN
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 785 5TH AVE STE 3
Address2:  
City: CHAMBERSBURG
State: PA
PostalCode: 172014232
CountryCode: US
TelephoneNumber: 7172639555
FaxNumber: 7172174218
Practice Location
Address1: 12 ST PAUL DR STE 207
Address2:  
City: CHAMBERSBURG
State: PA
PostalCode: 172011035
CountryCode: US
TelephoneNumber: 7172176882
FaxNumber: 7172176883
Other Information
ProviderEnumerationDate: 07/06/2011
LastUpdateDate: 03/18/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/18/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X4301098733MIN Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207V00000X35.126772OHN Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207V00000XMD458851PAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

ID Information
IDTypeStateIssuerDescription
10313140105PA MEDICAID


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