Individual
JENNIFER L CONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3399 POLLOCK RD, GRAND BLANC, MI 48439-8395
(810) 603-0170
(810) 603-2370
Mailing address
3399 POLLOCK RD, GRAND BLANC, MI 48439-8395
(810) 603-0170
(810) 579-1705
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
470424233
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
470424233
STATE LICENSE
MI
01
—
JC24233
BCBS STATE LICENSE
MI
Enumeration date
05/12/2010
Last updated
03/17/2018
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