Healthcare Provider Details

I. General information

NPI: 1992228571
Provider Name (Legal Business Name): VALERIE CONRAD FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2017
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 W 15TH ST
LIBERAL KS
67901-2464
US

IV. Provider business mailing address

445 W 15TH ST
LIBERAL KS
67901-2464
US

V. Phone/Fax

Practice location:
  • Phone: 620-417-9012
  • Fax: 620-417-9013
Mailing address:
  • Phone: 620-417-9012
  • Fax: 620-417-9013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP134627
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP-59819
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-86177-011
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP61046887
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: