Basic Information
| Provider Information | |||||||||
| NPI: | 1093325144 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CONLEY | ||||||||
| FirstName: | KENLEY | ||||||||
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| Credential: | MSN, RN, ACCNS-AG | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9840 HONEYBEE DRIVE | ||||||||
| Address2: | |||||||||
| City: | MECHANICSVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 23116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7034003964 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8260 ATLEE RD | ||||||||
| Address2: | |||||||||
| City: | MECHANICSVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 231161844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8047647686 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2020 | ||||||||
| LastUpdateDate: | 08/04/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SA2100X | 0015001096 | VA | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Acute Care |
No ID Information.