NPI Number: 1689731895
Health Care Provider/Practitioner: ANNA KOKKALIS CONREY MSN, RN, CCRN, CRNP
Information about “1689731895” NPI (ANNA KOKKALIS CONREY MSN, RN, CCRN, CRNP)
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<?xml version="1.0" encoding="UTF-8"?>
<Npi>
<NPI>
1689731895
</NPI>
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Individual
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<EIN/>
<IsSoleProprietor>
N
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<LastName>
CONREY
</LastName>
<FirstName>
ANNA
</FirstName>
<MiddleName>
KOKKALIS
</MiddleName>
<NamePrefix>
MS.
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MSN, RN, CCRN, CRNP
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<OtherLastName/>
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<FirstLineMailingAddress>
410 KOJUN CT
</FirstLineMailingAddress>
<SecondLineMailingAddress/>
<MailingAddressCityName>
STERLING
</MailingAddressCityName>
<MailingAddressStateName>
VA
</MailingAddressStateName>
<MailingAddressPostalCode>
20164-5533
</MailingAddressPostalCode>
<MailingAddressCountryCode>
US
</MailingAddressCountryCode>
<MailingAddressTelephoneNumber>
732-644-7820
</MailingAddressTelephoneNumber>
<MailingAddressFaxNumber/>
<FirstLinePracticeLocationAddress>
NATIONAL INSTITUTES OF HEALTH
</FirstLinePracticeLocationAddress>
<SecondLinePracticeLocationAddress>
10 CENTER DRIVE, BLDG 10, CLINICAL CENTER - ROOM 5-5140
</SecondLinePracticeLocationAddress>
<PracticeLocationAddressCityName>
BETHESDA
</PracticeLocationAddressCityName>
<PracticeLocationAddressStateName>
MD
</PracticeLocationAddressStateName>
<PracticeLocationAddressPostalCode>
20892-0001
</PracticeLocationAddressPostalCode>
<PracticeLocationAddressCountryCode>
US
</PracticeLocationAddressCountryCode>
<PracticeLocationAddressTelephoneNumber>
301-451-6409
</PracticeLocationAddressTelephoneNumber>
<PracticeLocationAddressFaxNumber/>
<EnumerationDate>
01/03/2007
</EnumerationDate>
<LastUpdateDate>
12/10/2012
</LastUpdateDate>
<NPIDeactivationReasonCode/>
<NPIDeactivationReason/>
<NPIDeactivationDate/>
<NPIReactivationDate/>
<GenderCode>
F
</GenderCode>
<Gender>
Female
</Gender>
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<AuthorizedOfficialTitle/>
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<Taxonomies>
<Taxonomy>
<TaxonomyCode>
363LA2100X
</TaxonomyCode>
<TaxonomyName>
Acute Care Nurse Practitioner
</TaxonomyName>
<LicenseNumber>
AC000533
</LicenseNumber>
<LicenseNumberStateCode>
MD
</LicenseNumberStateCode>
<PrimaryTaxonomySwitch>
Y
</PrimaryTaxonomySwitch>
</Taxonomy>
</Taxonomies>
<HealthcareProviderTaxonomyGroups/>
</Npi>
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