Healthcare Provider Details

I. General information

NPI: 1467087262
Provider Name (Legal Business Name): JANET KAY MCCONNELL RN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2020
Last Update Date: 03/12/2020
Certification Date: 03/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3008 WEST PARK ROW
ARLINGTON TX
76013
US

IV. Provider business mailing address

3008 WEST PARK ROW
ARLINGTON TX
76013
US

V. Phone/Fax

Practice location:
  • Phone: 817-861-5522
  • Fax: 817-861-3525
Mailing address:
  • Phone: 817-861-5522
  • Fax: 817-861-3525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP100301
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: