Provider Demographics
NPI:1740781715
Name:CONARD, LINDSEY SHEA (OT)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:SHEA
Last Name:CONARD
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:SHEA
Other - Last Name:HERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:2114 WILLIAM FRANCIS CT
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-6352
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1920 LIBAL ST
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-2471
Practice Address - Country:US
Practice Address - Phone:920-432-5434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-26
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5787-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist