Individual
MATTHEW JAMES MCCONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1009 NOVUS DR STE 2, JOHNSON CITY, TN 37604-8237
(423) 283-0776
(423) 283-0549
Mailing address
1009 NOVUS DR STE 2, JOHNSON CITY, TN 37604-8237
(423) 283-0776
(423) 283-0549
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APN22292
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
TN
Enumeration date
02/09/2017
Last updated
07/27/2021
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