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General NPI Number Information
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NPI Number | 1831139765
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Entity Type | Individual
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Provider Name | KATRINA LYNN CONRAD MD
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Gender | Female
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 07/09/2024
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Provider Practice Location Address
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Address Line | 510 W 1ST AVE
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City | TOPPENISH
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State | WA
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Zip | 98948-1564
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Country | US
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Telephone | 509-865-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 308 EASTCHESTER DR
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City | MOREHEAD CITY
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State | NC
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Zip | 28557-9698
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Country | US
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Telephone | 252-725-7862
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 200201232
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 19792
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 207VB0002X
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Taxonomy Name | Obesity Medicine (Obstetrics & Gynecology) Physician
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License Number | MD204855
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD61534891
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License Number State | WA
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