Provider Demographics
NPI:1861644866
Name:CONLEY, FERANIE B (FNP)
Entity Type:Individual
Prefix:
First Name:FERANIE
Middle Name:B
Last Name:CONLEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 NORTH MAIN
Mailing Address - Street 2:
Mailing Address - City:LOVINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:88260-2830
Mailing Address - Country:US
Mailing Address - Phone:575-396-6611
Mailing Address - Fax:575-396-1454
Practice Address - Street 1:515 EAST MAIN
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-8119
Practice Address - Country:US
Practice Address - Phone:575-397-0560
Practice Address - Fax:575-396-1454
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX627101363LF0000X
NMCNP-02355363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX019049801Medicaid
NM84824549Medicaid
NM344348YNGGMedicare Oscar/Certification
NM84824549Medicaid
TX451845Medicare Oscar/Certification