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NPI Code Detail

MEDICARE: MS. ARDITH LOUISE CONWAY PMHNP

MEDICARE: MS. ARDITH LOUISE CONWAY PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerNURU1375AK
2363LF0000XFamily Nurse PractitionerNURU1375AK

General Provider Information

NPI Number : 1689850190
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ARDITH LOUISE CONWAY PMHNP
Provider Business Mailing Address
First Line : 2500 S WOODWORTH LOOP
Second Line :
City : PALMER
State : AK
Zip : 99645-8984
Country : US
Telephone Number : 907-861-6000
Fax Number :
Provider Business Practice Location Address
First Line : 2500 S WOODWORTH LOOP
Second Line :
City : PALMER
State : AK
Zip : 99645-8984
Country : US
Telephone Number : 907-861-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2008
Last Update Date : 01/13/2026

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