Provider Demographics
NPI:1083043509
Name:OCONNELL, PATRICIA E (RN, MED IBCLC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:E
Last Name:OCONNELL
Suffix:
Gender:F
Credentials:RN, MED IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:LYNDEBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03082-6105
Mailing Address - Country:US
Mailing Address - Phone:603-801-1587
Mailing Address - Fax:
Practice Address - Street 1:1124 CENTER RD
Practice Address - Street 2:
Practice Address - City:LYNDEBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03082-6105
Practice Address - Country:US
Practice Address - Phone:603-801-1587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH028960-21163W00000X
NHL-31470163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant