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General NPI Number Information
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NPI Number | 1740886316
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Entity Type | Individual
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Provider Name | CORLYN MCCONNELL CRNP, FNP-C,PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/09/2020
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 241 MAPLE HOLLOW RD
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City | DUNCANSVILLE
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State | PA
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Zip | 16635-7006
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Country | US
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Telephone | 814-693-1415
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Fax |
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Provider Business Mailing Address
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Address Line | 357 MYERS ST
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City | EBENSBURG
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State | PA
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Zip | 15931-1721
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Country | US
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Telephone | 814-341-8408
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP022912
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP032475
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License Number State | PA
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