Provider Demographics
NPI:1538974258
Name:GARRETT, CONNIE JO
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:JO
Last Name:GARRETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2559 HOGANS ALY
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IN
Mailing Address - Zip Code:46733-3369
Mailing Address - Country:US
Mailing Address - Phone:260-610-8585
Mailing Address - Fax:
Practice Address - Street 1:2559 HOGANS ALY
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IN
Practice Address - Zip Code:46733-3369
Practice Address - Country:US
Practice Address - Phone:260-610-8585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide