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Individual
KATHLEEN M CONNELL
Active
Individual
KATHLEEN M CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
KC046039
MI
208D00000X
General Practice Physician
Primary
KC046039
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1001492
MCLAREN
MI
01
—
700C361780
BCBS
MI
01
—
KC046039
LICENSE NUMBER
MI
Enumeration date
01/31/2007
Last updated
01/21/2011
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