Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 58914 | MN |
NPI | 1013202100 |
---|---|
Provider Name | Dr. Brittani Lauren Conway |
First Address | Bloomington, MN 55425-4516 |
Second Address | Saint Paul, MN 55130-5302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2011 |
Last Update Date | 11/11/2021 |