Provider Demographics
NPI:1508541491
Name:CONLEY, STEVEN LYNN
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:LYNN
Last Name:CONLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2534 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-6411
Mailing Address - Country:US
Mailing Address - Phone:304-834-1211
Mailing Address - Fax:681-245-6354
Practice Address - Street 1:2534 15TH AVE
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-6411
Practice Address - Country:US
Practice Address - Phone:304-834-1211
Practice Address - Fax:681-245-6354
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVN2T173343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)