Basic Information
| Provider Information | |||||||||
| NPI: | 1194071332 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CONNORS | ||||||||
| FirstName: | VENUS | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9529 FORDHAM RD | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191142612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2673351508 | ||||||||
| FaxNumber: | 2153811530 | ||||||||
| Practice Location | |||||||||
| Address1: | 5457 WAYNE AVE | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191443433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2673351500 | ||||||||
| FaxNumber: | 2153811530 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2012 | ||||||||
| LastUpdateDate: | 07/25/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN521135L | PA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.