| NPI | 1487948816 |
|---|---|
| Former Legal Business Name | CONNIE S. HERRON, PC |
| Entity Type | Organization |
| Authorized Contact | CONNIE S. COLE President/Owner 260-349-8185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: IN 55000068A) |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2014-08-04 |