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NPI Code Detail

MEDICARE: ROGER ALBERT CONANT

MEDICARE: ROGER ALBERT CONANT
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
1363LA2200XAdult Health Nurse Practitioner226870AZ

General Provider Information

NPI Number : 1487219317
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROGER ALBERT CONANT
Provider Business Mailing Address
First Line : PO BOX 35380
Second Line :
City : LAS VEGAS
State : NV
Zip : 89133-5380
Country : US
Telephone Number : 702-579-3203
Fax Number :
Provider Business Practice Location Address
First Line : 9801 N METRO PKWY E
Second Line :
City : PHOENIX
State : AZ
Zip : 85051-1513
Country : US
Telephone Number : 602-249-0115
Fax Number : 602-249-0837
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2019
Last Update Date : 10/24/2024

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Directions to “ ROGER ALBERT CONANT ” Practice Location

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