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Individual

ANGELA FAUN MCCONACHIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
576 MICHELLE DR, COLUMBIA, IL 62236-1547
(618) 972-6222
(314) 362-4870
Mailing address
576 MICHELLE DR, COLUMBIA, IL 62236-1547
(618) 972-6222
(314) 362-4870

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2005001438
MO
363LF0000X
Family Nurse Practitioner
209005323
IL

Other

Enumeration date
05/15/2009
Last updated
05/15/2009
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