Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 58411 | TN |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 58411 | TN |
NPI | 1639603640 |
---|---|
Provider Name | Dr. Nicholas Conley |
First Address | Nashville, TN 37228-1805 |
Second Address | Nashville, TN 37228-1805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2017 |
Last Update Date | 10/05/2021 |