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General NPI Number Information
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NPI Number | 1942923099
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Entity Type | Individual
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Provider Name | MELISSA SUE MCCONNELL CRNP
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Gender | Female
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Dates
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Enumeration Date | 09/23/2022
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Last Update Date | 09/23/2022
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Provider Practice Location Address
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Address Line | 160 S RAILROAD ST
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City | TROY
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State | PA
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Zip | 16947-1499
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Country | US
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Telephone | 570-215-3579
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Fax |
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Provider Business Mailing Address
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Address Line | 3324 FALL RUN RD
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City | WYSOX
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State | PA
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Zip | 18854-7812
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Country | US
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Telephone | 570-423-9957
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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 | SP026252
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License Number State | PA
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