Basic Information
| Provider Information | |||||||||
| NPI: | 1093781551 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AMES-CONNOR | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | M. | ||||||||
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| Credential: | C.R.N.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 10925 | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198500925 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8887337271 | ||||||||
| FaxNumber: | 3027330854 | ||||||||
| Practice Location | |||||||||
| Address1: | 640 S STATE ST | ||||||||
| Address2: | |||||||||
| City: | DOVER | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199013530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026744700 | ||||||||
| FaxNumber: | 3027330854 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2006 | ||||||||
| LastUpdateDate: | 11/11/2013 | ||||||||
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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 | 367500000X | L6-0A00425 | DE | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 163W00000X | L1-0014709 | DE | N | Nursing Service Providers | Registered Nurse | 163W00000X | 26NR05582900 | NJ | N | Nursing Service Providers | Registered Nurse | 163W00000X | RN334186L | PA | N | Nursing Service Providers | Registered Nurse |
ID Information
| ID | Type | State | Issuer | Description | 47027 | 01 | AANA | OTHER | P00615644 | 01 | DE | RAILROAD MEDICARE | OTHER |