Provider Demographics
NPI:1316989056
Name:CONRADT, KAY L (APNP)
Entity type:Individual
Prefix:
First Name:KAY
Middle Name:L
Last Name:CONRADT
Suffix:
Gender:F
Credentials:APNP
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2701 N ONEIDA ST
Mailing Address - Street 2:STE D FOX VALLEY NEPHROLOGY PARTNERS
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911
Mailing Address - Country:US
Mailing Address - Phone:920-730-4960
Mailing Address - Fax:920-739-0953
Practice Address - Street 1:2701 N ONEIDA ST
Practice Address - Street 2:FOX VALLEY NEPHROLOGY PARTNERS SC
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911
Practice Address - Country:US
Practice Address - Phone:920-730-4960
Practice Address - Fax:920-739-0953
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI235933363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41179800Medicaid
WI21280500Medicaid
Q06416Medicare UPIN