Provider Demographics
NPI:1538873534
Name:MCCONNELL, SERIA PAUSAL
Entity type:Individual
Prefix:MRS
First Name:SERIA
Middle Name:PAUSAL
Last Name:MCCONNELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2432 DERR RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45503-2442
Mailing Address - Country:US
Mailing Address - Phone:937-629-0461
Mailing Address - Fax:
Practice Address - Street 1:2432 DERR RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-2442
Practice Address - Country:US
Practice Address - Phone:937-629-0461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care