Krista Lynn Conde, RN

Individual provider Active NPI Registered Nurse · Dexter, MO

NPI 1992234066 · NPPES record last updated Jun 12, 2017

Key facts

NPI
1992234066
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
2011024571 (MO)
Practice address
916 Smith St
Dexter, MO 63841-2737
Phone
(573) 624-6937
NPI assigned
Jun 12, 2017
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2011024571MOMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Missouri Behavioral Health Inc Past Accepting new patients
Southeast Missouri Behavioral Health Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2011024571 MO Yes

Addresses

Primary practice location

916 Smith St
Dexter, MO 63841-2737

Mailing address

PO Box 459
Farmington, MO 63640-0459

Other providers in Dexter, MO

All providers in Dexter, MO · Registered Nurse in Missouri

Sources for this page

Verify at the official NPI Registry.