Barbara J McConnell, LPN, CHTP, CHTI

Individual provider Active NPI Licensed Practical Nurse · Grass Lake, MI

NPI 1992915862 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1992915862
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
4703013684 (MI)
Practice address
595 Island
Grass Lake, MI 49240-9623
Phone
(517) 522-4790
Fax
(517) 522-4110
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4703013684MIMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703013684 MI Yes

Addresses

Primary practice location

595 Island
Grass Lake, MI 49240-9623

Mailing address

595 Island
Grass Lake, MI 49240-9623
Phone (517) 522-4790

Other providers in Grass Lake, MI

All providers in Grass Lake, MI · Licensed Practical Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.