Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 69392 | GA |
N | 207V00000X | Obstetrician & Gynecologist | P8232 | TX |
Y | 207VX0201X | Gynecologic Oncologist | 32914 | NE |
N | 207VX0201X | Gynecologic Oncologist | 69392 | GA |
NPI | 1053554527 |
---|---|
Provider Name | Lesley B. Conrad |
First Address | Omaha, NE 68124-2311 |
Second Address | Omaha, NE 68124-2319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2009 |
Last Update Date | 03/11/2020 |