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NPI Code Detail

MEDICARE: MCKENNA PAIGE O'CONNOR PA-C

MEDICARE: MCKENNA PAIGE O'CONNOR PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1104605633
Entity Type Code : Individual
Provider Name (Legal Business Name) : MCKENNA PAIGE O'CONNOR PA-C
Provider Business Mailing Address
First Line : 689 SIERRA ROSE DR STE B
Second Line :
City : RENO
State : NV
Zip : 89511-2076
Country : US
Telephone Number : 775-636-7100
Fax Number : 775-636-6724
Provider Business Practice Location Address
First Line : 689 SIERRA ROSE DR STE B
Second Line :
City : RENO
State : NV
Zip : 89511-2076
Country : US
Telephone Number : 775-323-3000
Fax Number : 775-323-3001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2023
Last Update Date : 04/02/2026

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Directions to “ MCKENNA PAIGE O'CONNOR PA-C” Practice Location

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