Provider Demographics
NPI:1588967442
Name:MCDONNELL, CORYN NYDIA (AUD)
Entity type:Individual
Prefix:MISS
First Name:CORYN
Middle Name:NYDIA
Last Name:MCDONNELL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9202 W DODGE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3343
Mailing Address - Country:US
Mailing Address - Phone:402-933-3277
Mailing Address - Fax:
Practice Address - Street 1:9202 W DODGE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3343
Practice Address - Country:US
Practice Address - Phone:402-933-3277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-15
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE289231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist