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Individual
LISA B CONRY
Active
Individual
LISA B CONRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M. D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
14909
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051079402CON
BLUE CROSS BLUE SHIELD
AL
05
—
C000079402
—
AL
Enumeration date
07/10/2006
Last updated
12/19/2013
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