Provider Demographics
NPI:1952735144
Name:CONLEY, LORI JEAN (CNM)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:JEAN
Last Name:CONLEY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-6969
Practice Address - Street 1:175 MARTIN AVE
Practice Address - Street 2:SUITE 125
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-1761
Practice Address - Country:US
Practice Address - Phone:717-751-5700
Practice Address - Fax:717-721-5712
Is Sole Proprietor?:No
Enumeration Date:2013-08-25
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW010317367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife