Basic Information
| Provider Information | |||||||||
| NPI: | 1790868602 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCCONNELL | ||||||||
| FirstName: | ELEANOR | ||||||||
| MiddleName: | SCHILDWACHTER | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | RN, PHD, GCNS, BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3509 SAINT MARYS RD | ||||||||
| Address2: | |||||||||
| City: | HILLSBOROUGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272789757 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197328951 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 508 FULTON ST | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277053875 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9192866932 | ||||||||
| FaxNumber: | 9192866823 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2006 | ||||||||
| LastUpdateDate: | 09/07/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WG0600X | 059345 | NC | Y | Nursing Service Providers | Registered Nurse | Gerontology | 364SG0600X | 375572 | NC | N | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Gerontology |
No ID Information.