Provider Demographics
NPI:1104473388
Name:MCCONNELL-KELLY, MELINDA ESTHER
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:ESTHER
Last Name:MCCONNELL-KELLY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 MILL ST STE 400
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1562
Mailing Address - Country:US
Mailing Address - Phone:775-538-6700
Mailing Address - Fax:775-688-5878
Practice Address - Street 1:890 MILL ST STE 400
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1562
Practice Address - Country:US
Practice Address - Phone:775-538-6700
Practice Address - Fax:775-688-5878
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator