Individual
MRS. MALIA SENECA ANN MCCONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1375 N WATSON AVE, EAGLE, ID 83616-6675
(208) 401-6073
Mailing address
1375 N WATSON AVE, EAGLE, ID 83616-6675
(208) 401-6073
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53457
ID
Other
Enumeration date
08/28/2023
Last updated
03/27/2025
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