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Individual

ANNELIESE B CONWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
12 PETRA LN, ALBANY, NY 12205-4973
(518) 452-0445
(518) 452-3489
Mailing address
904 PINE VALLEY RD, HOOSICK FALLS, NY 12090-4219
(518) 686-7064

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
118012
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
118012
LPN LICENSE
NY
Enumeration date
05/04/2007
Last updated
07/08/2007
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