Provider Demographics
NPI:1609828789
Name:NANCY CONLEY MD FAMILY MEDICINE
Entity Type:Organization
Organization Name:NANCY CONLEY MD FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:G
Authorized Official - Last Name:CONLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-770-7112
Mailing Address - Street 1:18653 WEDGE PKWY
Mailing Address - Street 2:SUITE 130
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-3005
Mailing Address - Country:US
Mailing Address - Phone:775-770-7112
Mailing Address - Fax:775-770-7113
Practice Address - Street 1:18653 WEDGE PKWY
Practice Address - Street 2:SUITE 130
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-3005
Practice Address - Country:US
Practice Address - Phone:775-770-7112
Practice Address - Fax:775-770-7113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11917207Q00000X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVI55304Medicare UPIN