Provider Demographics
NPI:1811490519
Name:MCCONNELL, MEGAN KATHRYN (NP-C)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:KATHRYN
Last Name:MCCONNELL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 HEMLOCK CT
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-8072
Mailing Address - Country:US
Mailing Address - Phone:765-409-3755
Mailing Address - Fax:
Practice Address - Street 1:8244 E US HIGHWAY 36 STE 1310
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-9627
Practice Address - Country:US
Practice Address - Phone:317-838-9355
Practice Address - Fax:317-718-2955
Is Sole Proprietor?:No
Enumeration Date:2018-03-09
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28169473A163WE0003X
IN71008223A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency