Individual provider · Type 1 NPI

Jacob Connelly

Family Nurse Practitioner · Los Alamos, NM

NPI number 1790147593 Active

Practice location

3917 West Rd Ste A3917
Los Alamos, NM 87544-2275

Call (505) 661-8959 Map

Fax (505) 661-8916

Mailing address

3917 West Rd Ste A
Los Alamos, NM 87544-2292

Other practice locations

  • 8291 Dani Dr Ste 100, Fort Myers, FL 33966-8021 · (239) 931-6049
  • 737 Cape Coral Pkwy E, Cape Coral, FL 33904-8551 · (239) 542-0512

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000XRN 9409391 (FL)
Family Nurse Practitioner Primary 363LF0000X11005429 (FL)

Family Nurse Practitioner: Definition to come...

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About NPI 1790147593

Jacob Connelly's National Provider Identifier is 1790147593, issued on Mar 22, 2016. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Los Alamos, NM. The record was last updated on Aug 26, 2025.