Provider Demographics
NPI:1063814481
Name:CONROY, MARY REBECCA (NP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:REBECCA
Last Name:CONROY
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:1350 SOUTH ELISEO DRIVE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-2011
Mailing Address - Country:US
Mailing Address - Phone:415-925-7450
Mailing Address - Fax:415-925-7652
Practice Address - Street 1:1350 SOUTH ELISEO DRIVE
Practice Address - Street 2:SUITE 140
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2011
Practice Address - Country:US
Practice Address - Phone:415-925-7450
Practice Address - Fax:415-925-7652
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2023-04-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA95001243363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health