Healthcare Provider Details

I. General information

NPI: 1043014855
Provider Name (Legal Business Name): DAKOTA JAMES CONLEY FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2025
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

386 AIRPORT RD
CHAPMANVILLE WV
25508-9202
US

IV. Provider business mailing address

20 ALVIE KELLY DR
CHAPMANVILLE WV
25508-7457
US

V. Phone/Fax

Practice location:
  • Phone: 304-855-1200
  • Fax: 304-855-1230
Mailing address:
  • Phone: 304-785-5550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number106519
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: