Provider Demographics
NPI:1982973327
Name:CONKRIGHT, KRISTEENA (PA-C)
Entity Type:Individual
Prefix:
First Name:KRISTEENA
Middle Name:
Last Name:CONKRIGHT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KRISTEENA
Other - Middle Name:
Other - Last Name:ABNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:222 MEDICAL CIR
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351-1179
Mailing Address - Country:US
Mailing Address - Phone:606-783-6500
Mailing Address - Fax:
Practice Address - Street 1:2195 HARRODSBURG RD STE 125
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3543
Practice Address - Country:US
Practice Address - Phone:859-257-9255
Practice Address - Fax:859-257-3585
Is Sole Proprietor?:No
Enumeration Date:2011-12-14
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA1681363AM0700X, 363AS0400X, 363A00000X
363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100185480Medicaid
KY7100185480Medicaid