Provider Demographics
NPI:1790868602
Name:MCCONNELL, ELEANOR SCHILDWACHTER (RN, PHD, GCNS, BC)
Entity Type:Individual
Prefix:DR
First Name:ELEANOR
Middle Name:SCHILDWACHTER
Last Name:MCCONNELL
Suffix:
Gender:F
Credentials:RN, PHD, GCNS, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3509 SAINT MARYS RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-9757
Mailing Address - Country:US
Mailing Address - Phone:919-732-8951
Mailing Address - Fax:
Practice Address - Street 1:508 FULTON ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3875
Practice Address - Country:US
Practice Address - Phone:919-286-6932
Practice Address - Fax:919-286-6823
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2008-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC059345163WG0600X
NC375572364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology
No364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology