Provider Demographics
NPI:1538817481
Name:CONLEY, SHARY (LPN)
Entity type:Individual
Prefix:
First Name:SHARY
Middle Name:
Last Name:CONLEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:SHARY
Other - Middle Name:
Other - Last Name:POSADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:1245 BIRCH AVE
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97424-1413
Mailing Address - Country:US
Mailing Address - Phone:541-767-6085
Mailing Address - Fax:
Practice Address - Street 1:1245 BIRCH AVE
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:OR
Practice Address - Zip Code:97424-1413
Practice Address - Country:US
Practice Address - Phone:541-767-6085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-10
Last Update Date:2022-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202101576LPN164W00000X
OR101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse