Individual
FREDDY D CONLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
17978 SR 55, BAKER, WV 26801
(304) 897-5915
(304) 897-6216
Mailing address
PO BOX 97, BAKER, WV 26801-0097
(304) 897-5915
(304) 897-6216
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
82984
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82984
WV STATE LICENSE NUMBER
WV
Enumeration date
07/20/2012
Last updated
09/23/2013
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