Individual
KEVIN CHARLES CONLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8 DOGWOOD LANE, MOUNTAIN HOME, TN 37684
(423) 926-1171
Mailing address
101 SANTA FE DR, BRISTOL, TN 37620-6439
(423) 534-2182
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
30041
TN
Other
Enumeration date
12/03/2021
Last updated
12/03/2021
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