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NPI Code Detail

MEDICARE: MS. SUSAN DAILEY MCCONNELL N.P.

MEDICARE: MS. SUSAN DAILEY MCCONNELL N.P.
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
1363LA2200XAdult Health Nurse PractitionerRN037067GA

General Provider Information

NPI Number : 1457352197
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSAN DAILEY MCCONNELL N.P.
Provider Business Mailing Address
First Line : 2918 GALAHAD DR NE
Second Line :
City : ATLANTA
State : GA
Zip : 30345-3633
Country : US
Telephone Number : 404-634-7069
Fax Number :
Provider Business Practice Location Address
First Line : 1670 CLAIRMONT RD
Second Line :
City : DECATUR
State : GA
Zip : 30033-4004
Country : US
Telephone Number : 404-321-6111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2005
Last Update Date : 07/08/2007

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