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NPI Code Detail

MEDICARE: DR. WILDYA CONDE DNP, APRN, FNP-BC

MEDICARE: DR. WILDYA CONDE DNP, APRN, FNP-BC
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
1363LF0000XFamily Nurse Practitioner11002788FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851951990
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILDYA CONDE DNP, APRN, FNP-BC
Provider Business Mailing Address
First Line : 1404 S 28TH ST
Second Line :
City : FORT PIERCE
State : FL
Zip : 34947-6999
Country : US
Telephone Number : 772-293-0770
Fax Number :
Provider Business Practice Location Address
First Line : 1404 S 28TH ST
Second Line :
City : FORT PIERCE
State : FL
Zip : 34947-6999
Country : US
Telephone Number : 772-293-0770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2019
Last Update Date : 04/06/2021

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