Provider Demographics
NPI:1851628317
Name:MCCONNELL, CHRISTINA I
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:I
Last Name:MCCONNELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 SHEPARD PL NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-1732
Mailing Address - Country:US
Mailing Address - Phone:505-918-1717
Mailing Address - Fax:
Practice Address - Street 1:3310 SHEPARD PL NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-1732
Practice Address - Country:US
Practice Address - Phone:505-918-1717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide