Healthcare Provider Details

I. General information

NPI: 1891605218
Provider Name (Legal Business Name): CHARLOTTE HIRST MCCONNELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHARLIE HIRST

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 S WINTER ST STE 1022
ADRIAN MI
49221-3876
US

IV. Provider business mailing address

9235 YORKSHIRE DR
SALINE MI
48176-9444
US

V. Phone/Fax

Practice location:
  • Phone: 517-264-0122
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: