Healthcare Provider Details

I. General information

NPI: 1306578919
Provider Name (Legal Business Name): KADY HURST CONRAD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2022
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2660 TATE BLVD SE STE 202
HICKORY NC
28602-1466
US

IV. Provider business mailing address

PO BOX 1845
STATESVILLE NC
28687-1845
US

V. Phone/Fax

Practice location:
  • Phone: 704-978-1145
  • Fax: 980-829-0487
Mailing address:
  • Phone: 704-873-4277
  • Fax: 704-978-3549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5016455
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: