Provider Demographics
NPI:1194431684
Name:CONLEY, AMANDA LEE (RN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LEE
Last Name:CONLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 E ARMY POST RD
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50315-5957
Mailing Address - Country:US
Mailing Address - Phone:515-256-9540
Mailing Address - Fax:515-256-9602
Practice Address - Street 1:1211 E ARMY POST RD
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50315-5957
Practice Address - Country:US
Practice Address - Phone:515-256-9540
Practice Address - Fax:515-256-9602
Is Sole Proprietor?:No
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA143511163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice