Jenine Louise Conrad

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024175628 Issued in VA

Practice address

600 W Hillsboro Blvd Ste 10
Deerfield Beach, FL 33441-1609

Phone

(186) 644-8771

Fax

(954) 596-4746

NPI assigned

Feb 13, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518480000000",
    "number": "1710487103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5615 BARBARY COAST DR",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285609708",
            "telephone_number": "434-953-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W HILLSBORO BLVD STE 10",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334411609",
            "telephone_number": "186-644-8771",
            "fax_number": "954-596-4746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "JENINE",
        "middle_name": "LOUISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-13",
        "last_updated": "2018-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024175628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connect & Thrive
• Connect Care Clinic, Inc.
• Connection - Transdisciplinary Therapeutic Support Center, LLC
• Colleen Marie Connell
• Carey Anne Connolly, D.O.
• Megan Anne Conrad
• Zamir Consuegra Quesada, APRN
• Helen Casey Contento
• Michael Contrelli
• Isabella Convers Cardenas

• Family Nurse Practitioner in Deerfield Beach, FL
• Providers in Deerfield Beach, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.