Healthcare Provider Details

I. General information

NPI: 1083043509
Provider Name (Legal Business Name): PATRICIA E OCONNELL RN, M.ED. IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2013
Last Update Date: 11/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1124 CENTER RD
LYNDEBOROUGH NH
03082-6105
US

IV. Provider business mailing address

1124 CENTER RD
LYNDEBOROUGH NH
03082-6105
US

V. Phone/Fax

Practice location:
  • Phone: 603-801-1587
  • Fax:
Mailing address:
  • Phone: 603-801-1587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number028960-21
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-31470
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: