Kellie Conley
Individual provider Active NPI Nurse Practitioner · Radcliff, KY
NPI 1669967808 · NPPES record last updated Jun 29, 2018
Key facts
- NPI
- 1669967808
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 3012455 (KY)
- Practice address
- 1679 N Wilson Rd Ste 110
Radcliff, KY 40160-1569 - Phone
- (270) 272-0000
- Fax
- (270) 352-2530
- NPI assigned
- Jun 29, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Interoperability endpoints
- kconley@hardinmemorial.gwaydirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 3012455 | KY | Yes |
Addresses
Primary practice location
1679 N Wilson Rd Ste 110
Radcliff, KY 40160-1569
Mailing address
1679 N Wilson Rd Ste 110
Radcliff, KY 40160-1569
Phone (270) 272-0000
Other providers in Radcliff, KY
- Kelcie D Cobb
- Ramona N Coffie
- Felty Blake Colwell
- Commonwealth of Kentucky
- Communicare Inc
- Philip Cornette III
- Jess Cowman
- Ashley Craig
- David Brian Criscola
- Elouise Cross
All providers in Radcliff, KY · Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.