Provider Demographics
NPI:1154928794
Name:CAREY, CONYA JEAN
Entity type:Individual
Prefix:
First Name:CONYA
Middle Name:JEAN
Last Name:CAREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2341 MIAMI CONSERVANCY RD
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-8802
Mailing Address - Country:US
Mailing Address - Phone:937-538-9308
Mailing Address - Fax:
Practice Address - Street 1:193 MERCURY CT
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-1551
Practice Address - Country:US
Practice Address - Phone:937-538-9308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide