Individual
SHARON DIXIE MCCONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
9911 SE MOUNT SCOTT BLVD, PORTLAND, OR 97266-6302
(801) 703-3482
Mailing address
9911 SE MOUNT SCOTT BLVD, PORTLAND, OR 97266-6302
(801) 703-3482
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
353858-3102
UT
163WG0000X
General Practice Registered Nurse
RN-301406
OH
163WG0000X
General Practice Registered Nurse
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
353858-3102
RN LICENSE
UT
01
—
RN-301406
RN LICENSE
OH
Enumeration date
01/16/2006
Last updated
08/03/2007
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