Provider Demographics
NPI:1215758800
Name:MCCONNELL, RONALD ALAN (NREMT)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:ALAN
Last Name:MCCONNELL
Suffix:
Gender:M
Credentials:NREMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 MAPLE MNR
Mailing Address - Street 2:
Mailing Address - City:VERGENNES
Mailing Address - State:VT
Mailing Address - Zip Code:05491-8666
Mailing Address - Country:US
Mailing Address - Phone:802-238-0903
Mailing Address - Fax:
Practice Address - Street 1:17 MAPLE MNR
Practice Address - Street 2:
Practice Address - City:VERGENNES
Practice Address - State:VT
Practice Address - Zip Code:05491-8666
Practice Address - Country:US
Practice Address - Phone:802-238-0903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT146N00000X, 224Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic