Provider Demographics
NPI:1972234094
Name:MCCONNELL, ANNA KAITLYNN (PA)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:KAITLYNN
Last Name:MCCONNELL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16 COYOTE LN
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-3157
Mailing Address - Country:US
Mailing Address - Phone:828-400-7872
Mailing Address - Fax:
Practice Address - Street 1:80 DOCTORS DR STE 1
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-7289
Practice Address - Country:US
Practice Address - Phone:828-654-0073
Practice Address - Fax:828-681-5036
Is Sole Proprietor?:No
Enumeration Date:2022-06-20
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-13538363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical