Provider Demographics
NPI:1538347877
Name:CONRAD, COURTNEY G (LPN)
Entity type:Individual
Prefix:MISS
First Name:COURTNEY
Middle Name:G
Last Name:CONRAD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 TAURUS RD
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12304-2430
Mailing Address - Country:US
Mailing Address - Phone:518-641-2193
Mailing Address - Fax:
Practice Address - Street 1:217 TAURUS RD
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12304-2430
Practice Address - Country:US
Practice Address - Phone:518-641-2193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY281825164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse