Provider Demographics
NPI:1154145415
Name:CONOVER, CAROLYN (NP)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:CONOVER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 HAMLET CT
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-4448
Mailing Address - Country:US
Mailing Address - Phone:914-329-6239
Mailing Address - Fax:
Practice Address - Street 1:60 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-4133
Practice Address - Country:US
Practice Address - Phone:845-480-6678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY800158163W00000X
NV889647363LP0808X
NY407188363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse