Provider Demographics
NPI:1043347453
Name:CONAWAY, CAROLYN J (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:J
Last Name:CONAWAY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 SW 15TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-4333
Mailing Address - Country:US
Mailing Address - Phone:785-273-8224
Mailing Address - Fax:785-273-8412
Practice Address - Street 1:4100 SW 15TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-4333
Practice Address - Country:US
Practice Address - Phone:785-273-8224
Practice Address - Fax:785-273-8412
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-53066-031363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100255410BMedicaid
KSKA2129008Medicare PIN