KATHLEEN LYNN CONNERY PA-CMPAC NPI 1720006927

NPI Information

NPI: 1720006927
Provider Name: KATHLEEN LYNN CONNERY, PA-C,MPAC
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
6420 W NEWBERRY RD
EAST WING, SUITE 100
GAINESVILLE, FL
ZIP 32605
Phone: (352) 332-3900
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Kathleen Lynn Connery, PA-C,MPAC is a medical physician assistant in Gainesville, FL. Kathleen Lynn Connery, PA-C,MPAC NPI is 1720006927. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

6420 W NEWBERRY RD
EAST WING, SUITE 100
GAINESVILLE, FL
ZIP 32605-308
Phone: (352) 332-3900
Fax: (352) 332-5009

The NPI 1720006927 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/17/2006 and was last updated on 11/8/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA9103117	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	292508700	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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