Provider Demographics
NPI:1164768479
Name:CONLEY, KARA L (FNP-C)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:L
Last Name:CONLEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4003 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:24605-2043
Mailing Address - Country:US
Mailing Address - Phone:276-322-2085
Mailing Address - Fax:
Practice Address - Street 1:340 PEPPERS FERRY RD
Practice Address - Street 2:
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-2091
Practice Address - Country:US
Practice Address - Phone:276-250-1675
Practice Address - Fax:206-203-0141
Is Sole Proprietor?:No
Enumeration Date:2012-12-14
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV60326363LF0000X
VA0024172649363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily