Provider Demographics
NPI:1346689882
Name:CONLEY, PRISCILLA (RN'MSN)
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:
Last Name:CONLEY
Suffix:
Gender:F
Credentials:RN'MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11905 BLACKHAWK CIR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-1405
Mailing Address - Country:US
Mailing Address - Phone:513-476-2233
Mailing Address - Fax:859-491-2507
Practice Address - Street 1:11905 BLACKHAWK CIR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-1405
Practice Address - Country:US
Practice Address - Phone:513-476-2233
Practice Address - Fax:859-491-2507
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-18
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN170664163WA0400X, 163WC0400X, 163WH0200X, 163WP0809X, 163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation