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NPI Lookup from the NPI Registry — National Provider Identifier Database

GLENDA A MCCONNELL, PMHNP, BC – NPI #1316011653
Psychiatric/Mental Health


Contact Information

GLENDA A MCCONNELL, PMHNP, BC
3021 HOLMGREN WAY
SUITE 203-A
GREEN BAY, WI54304-6302
 Phone: 920-339-9307
 Fax: 920-339-9374
 Website:
 

Taxonomy / Specialty

Taxonomy Code

Psychiatric/Mental Health

363LP0808X
 

Psychiatric/Mental Health, Child & Adolescent

163WP0807X
Indicates primary specialty
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NPI Information for GLENDA A MCCONNELL · (Female)

NPI Number 1316011653
Credentials PMHNP, BC
Entity Individual
Enumeration date 11/20/2006
Last updated 08/01/2011 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
WI License # 2515-033
WI Medicaid 43600000
WI Medicare (Unspecified) 0014
WI Other 2515-033 ADVANCED PRACTICE NURSE PRESCRIBER
WI Other 391047205011 ANTHEM BLUE CROSS
WI Other MM1168219 DEA NUMBER
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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