Provider Demographics
NPI:1255073664
Name:CONNELL, RACHEL LOUISE
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:LOUISE
Last Name:CONNELL
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 1:1521 W WINDEMERE AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-2442
Mailing Address - Country:US
Mailing Address - Phone:248-765-6299
Mailing Address - Fax:
Practice Address - Street 1:DAYTON CHILDRENS HOSPITAL
Practice Address - Street 2:1 CHILDRENS PLAZA
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45404
Practice Address - Country:US
Practice Address - Phone:937-641-3433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2023-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program