Individual
MARYKATE CONROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1808 COLONIAL VILLAGE LN STE 103, LANCASTER, PA 17601-6709
(484) 818-0052
Mailing address
4600 E HARRISBURG PIKE, ELIZABETHTOWN, PA 17022-9004
(484) 818-0052
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN627315
PA
363LF0000X
Family Nurse Practitioner
SP024376
PA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP024376
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN627315
RN LICENSE
—
01
—
SP024376
NURSE PRACTITIONER LICENSE
PA
Enumeration date
06/16/2020
Last updated
09/13/2024
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