Basic Information
| Provider Information | |||||||||
| NPI: | 1558696872 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCCONNELL | ||||||||
| FirstName: | BRIANA | ||||||||
| MiddleName: | PATRICIA | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 105 BROOKINGS ST | ||||||||
| Address2: | |||||||||
| City: | MEDFORD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021555446 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7813938874 | ||||||||
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| Practice Location | |||||||||
| Address1: | 77 E MERRIMACK ST STE 1 | ||||||||
| Address2: | |||||||||
| City: | LOWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018521900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9784536800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2009 | ||||||||
| LastUpdateDate: | 10/04/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN2261341 | MA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.