Healthcare Provider Details

I. General information

NPI: 1922806199
Provider Name (Legal Business Name): JENNIFER ANNE CONLEY MSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12800 CORPORATE HILL DR FL 2
SAINT LOUIS MO
63131-1845
US

IV. Provider business mailing address

12800 CORPORATE HILL DR FL 2
SAINT LOUIS MO
63131-1845
US

V. Phone/Fax

Practice location:
  • Phone: 314-682-1910
  • Fax:
Mailing address:
  • Phone: 314-682-1910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number2018019448
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number041381062
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: