Individual
TIPPINI K CONLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
14101 HICKORY STREET, OAKLAND, MS 38948-0000
(662) 623-7319
(662) 473-4991
Mailing address
14101 HICKORY STREET, OAKLAND, MS 38948-0000
(662) 623-7319
(662) 473-4991
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R866055
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01802340
—
MS
01
—
512I500752
MEDICARE PTAN
MS
Enumeration date
08/13/2008
Last updated
01/10/2024
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