Provider Demographics
NPI:1497647416
Name:MCCONNELL, KATRINA (FNP)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:MCCONNELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 NOAH LN
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-3696
Mailing Address - Country:US
Mailing Address - Phone:256-283-3628
Mailing Address - Fax:
Practice Address - Street 1:150 NOAH LN
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203-3696
Practice Address - Country:US
Practice Address - Phone:256-283-3628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALF06251657207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine