Provider Demographics
NPI:1255645552
Name:CONARD, MELISSA MEGAN (APRN)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:MEGAN
Last Name:CONARD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 828
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:KS
Mailing Address - Zip Code:67554-0828
Mailing Address - Country:US
Mailing Address - Phone:620-257-5173
Mailing Address - Fax:620-257-2608
Practice Address - Street 1:619 S CLARK AVE
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:KS
Practice Address - Zip Code:67554-3003
Practice Address - Country:US
Practice Address - Phone:620-257-5173
Practice Address - Fax:620-257-2608
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-75143367A00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200671080BMedicaid
KSKA1948018Medicare PIN