MEDICARE: PATSY ANN CONROD FNP B. C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	NURU1126	AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447560248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATSY ANN CONROD FNP B. C.

Provider Business Mailing Address
First Line	:	1730 A WILDLIFE LANE
Second Line	:
City	:	BETHEL
State	:	AK
Zip	:	99559-2881
Country	:	US
Telephone Number	:	907-543-2871
Fax Number	:

Provider Business Practice Location Address
First Line	:	631 MAIN STREET
Second Line	:
City	:	BETHEL
State	:	AK
Zip	:	99559-1908
Country	:	US
Telephone Number	:	907-543-3773
Fax Number	:	907-543-3545

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2010
Last Update Date	:	08/14/2024

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