Provider Demographics
NPI:1649269762
Name:CONRAD, VAUN KAY (ARNP)
Entity type:Individual
Prefix:MRS
First Name:VAUN
Middle Name:KAY
Last Name:CONRAD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:11707 SE 174TH LOOP
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491-7834
Mailing Address - Country:US
Mailing Address - Phone:352-629-0137
Mailing Address - Fax:352-694-4824
Practice Address - Street 1:7960 SW 60TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-6457
Practice Address - Country:US
Practice Address - Phone:352-671-6741
Practice Address - Fax:352-671-6742
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1671172363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0334154-00Medicaid
FL0334154-00Medicaid
FLS82525Medicare UPIN