CAROLINE L CONNELLY FNP NPI 1790093391

NPI Information

NPI: 1790093391
Provider Name: CAROLINE L CONNELLY, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
691 MURPHY RD
SUITE 107
MEDFORD, OR
ZIP 97504
Phone: (541) 789-6460
Get Directions

Caroline L Connelly, FNP is a family nurse practitioner in Medford, OR. Caroline L Connelly, FNP NPI is 1790093391. 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:

691 MURPHY RD
SUITE 107
MEDFORD, OR
ZIP 97504-346
Phone: (541) 789-6460
Fax: (541) 789-6461

The enumeration date for this NPI number is 9/16/2010 and was last updated on 10/13/2015.

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	363L00000X	Nurse Practitioner		201020177NP	OREGON	No
2	363LF0000X	Nurse Practitioner	Family	201050177NP	OREGON	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
1	500629732	MEDICAID	OREGON
2	R156535	MEDICARE PIN	OREGON
3	R104443	MEDICARE PIN	OREGON

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: 4/28/2024

NPI Synchronization or Removal

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