Healthcare Provider Details

I. General information

NPI: 1336093749
Provider Name (Legal Business Name): CHASTITY CONLEY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 LEXINGTON RD STE F
RICHMOND KY
40475-7924
US

IV. Provider business mailing address

2150 LEXINGTON RD STE F
RICHMOND KY
40475-7924
US

V. Phone/Fax

Practice location:
  • Phone: 859-940-1414
  • Fax: 859-208-1157
Mailing address:
  • Phone: 859-712-0955
  • Fax: 859-208-1157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHASTITY CONLEY
Title or Position: OWNER
Credential: APRN
Phone: 859-940-1414