MEDICARE: SANDRA CONLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1366235541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA CONLEY

Provider Business Mailing Address
First Line	:	226 FRONT ST
Second Line	:
City	:	BRIDGEPORT
State	:	WV
Zip	:	26330-1524
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	226 FRONT ST
Second Line	:
City	:	BRIDGEPORT
State	:	WV
Zip	:	26330-1524
Country	:	US
Telephone Number	:	304-629-9080
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2025
Last Update Date	:	05/28/2025

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Directions to “ SANDRA CONLEY ” Practice Location

Language	Start Address	Practice Location

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