Provider Demographics
NPI:1952808958
Name:CONLEY, DENAYA DANYELLE (DO)
Entity Type:Individual
Prefix:DR
First Name:DENAYA
Middle Name:DANYELLE
Last Name:CONLEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:DENAYA
Other - Middle Name:DANYELLE
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1665 S GREEN ST
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-6556
Mailing Address - Country:US
Mailing Address - Phone:662-377-2189
Mailing Address - Fax:
Practice Address - Street 1:1665 S GREEN ST
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-6556
Practice Address - Country:US
Practice Address - Phone:662-377-2189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-07
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4275207Q00000X
390200000X
MS30692207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program