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General NPI Number Information
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NPI Number | 1801354352
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Entity Type | Individual
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Provider Name | ASHLEY ELIZABETH CONRAD ATC
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Gender | Female
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Dates
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Enumeration Date | 03/04/2019
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Last Update Date | 03/04/2019
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Provider Practice Location Address
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Address Line | 1100 W 14TH ST
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City | HASTINGS
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State | NE
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Zip | 68901-3064
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Country | US
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Telephone | 307-689-7325
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Fax |
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Provider Business Mailing Address
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Address Line | 215 E 9TH ST
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City | HASTINGS
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State | NE
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Zip | 68901-4066
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Country | US
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Telephone | 307-689-7325
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Fax |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 667
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License Number State | NE
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