Individual
CLAYTON CONDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
3 AUDUBON PLAZA DR STE 550, LOUISVILLE, KY 40217-1376
(502) 634-3805
(502) 634-9336
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
3017674
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3017674
STATE LICENSE
KY
Enumeration date
04/22/2022
Last updated
12/29/2023
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