Provider Demographics
NPI:1962161836
Name:MCCONNELL, ELLE (NP-C)
Entity type:Individual
Prefix:
First Name:ELLE
Middle Name:
Last Name:MCCONNELL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1798 PLANK RD STE 201
Mailing Address - Street 2:
Mailing Address - City:DUNCANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16635-8389
Mailing Address - Country:US
Mailing Address - Phone:814-696-3397
Mailing Address - Fax:
Practice Address - Street 1:1798 PLANK RD STE 201
Practice Address - Street 2:
Practice Address - City:DUNCANSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16635-8389
Practice Address - Country:US
Practice Address - Phone:814-696-3397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-08
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP025043363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner