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: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6330 RIVERSIDE PLAZA LN NW STE 100
ALBUQUERQUE NM
87120-2682
US

IV. Provider business mailing address

912 W 21ST ST STE 100
CLOVIS NM
88101-4149
US

V. Phone/Fax

Practice location:
  • Phone: 505-322-6687
  • Fax: 505-369-3406
Mailing address:
  • Phone: 575-904-7577
  • Fax: 505-369-3406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP134627
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP-59819
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP61046887
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: