Provider Demographics
NPI:1508838152
Name:CONARD, LEE ANN ELIZABETH (RPH, DO, MPH)
Entity Type:Individual
Prefix:DR
First Name:LEE ANN
Middle Name:ELIZABETH
Last Name:CONARD
Suffix:
Gender:F
Credentials:RPH, DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:ML 4000
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-4681
Mailing Address - Fax:513-636-8844
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:ML 4000
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4681
Practice Address - Fax:513-636-8844
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.006460208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001921541Medicaid
PA083237EB0Medicare ID - Type Unspecified
PAH71027Medicare UPIN