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Individual

JACK EDWARD CONEBY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RNBC

Contact information

Practice address
3820 CENTRAL AVE, ST PETERSBURG, FL 33711-1237
(727) 543-9416
Mailing address
3820 CENTRAL AVE, ST PETERSBURG, FL 33711-1237
(727) 543-9416

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
RN1461352
FL

Other

Enumeration date
08/22/2011
Last updated
08/22/2011
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