Provider Demographics
NPI:1871801365
Name:CONLEY, STEPHANIE CAROLINE (ANP-BC)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:CAROLINE
Last Name:CONLEY
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 WINDCROSS CT
Mailing Address - Street 2:STE 101
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2678
Mailing Address - Country:US
Mailing Address - Phone:615-224-5438
Mailing Address - Fax:
Practice Address - Street 1:475 KILVERT ST
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1379
Practice Address - Country:US
Practice Address - Phone:615-224-5438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-17
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN284380363LA2200X
RINPP37841363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health