Individual provider · NPI-1

Michael Eugene Conner III, RN

Registered Nurse, General Practice · Oklahoma City, OK

NPI number1235642497

StatusActive

Last updated in NPPESNov 9, 2017

Details

NPI: 1235642497
Entity type: Individual (NPI-1)
Name: Mr. Michael Eugene Conner III
Credential: RN
Sex: Male
Sole proprietor: Yes
Enumeration date: Nov 9, 2017
Last updated: Nov 9, 2017

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
163WG0000X	Registered Nurse, General Practice	126799	OK	Yes
1710I1003X	Military Health Care Provider, Independent Duty Medical Technicians	–	–
3416L0300X	Ambulance, Land Transport	–	–
146M00000X	Emergency Medical Technician, Intermediate	28283	OK

Practice location

921 Ne 13th St
Oklahoma City, OK 73104-5007

Phone 405-456-5607

Mailing address

1008 S Ellison Ave
El Reno, OK 73036-5322

Phone 405-200-9579

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