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General NPI Number Information
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NPI Number | 1730181322
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Entity Type | Individual
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Provider Name | MARY CELESTE CONLON FNP
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Gender | Female
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Dates
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Enumeration Date | 08/12/2005
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Last Update Date | 07/12/2022
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Provider Practice Location Address
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Address Line | 2550 ELMS CENTER RD
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City | N CHARLESTON
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State | SC
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Zip | 29406-9844
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Country | US
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Telephone | 843-832-8840
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Fax | 843-818-2188
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Provider Business Mailing Address
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Address Line | 2550 ELMS CENTER RD
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City | N CHARLESTON
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State | SC
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Zip | 29406-9844
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Country | US
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Telephone | 843-302-8840
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Fax | 843-818-2188
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 709848
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 448
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License Number State | SC
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