Provider Demographics
NPI:1487634614
Name:CONLEY, RUTH ELIZABETH (NP-C)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:ELIZABETH
Last Name:CONLEY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6767 29TH ST
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-5474
Mailing Address - Country:US
Mailing Address - Phone:970-652-2780
Mailing Address - Fax:970-652-2797
Practice Address - Street 1:6767 29TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-5474
Practice Address - Country:US
Practice Address - Phone:970-652-2780
Practice Address - Fax:970-652-2797
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001459A363LF0000X
MI4704251101363LF0000X
COAPN.0992441-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000388407OtherANTHEM-BCBS
MI1487634614Medicaid
IN200814380Medicaid
CO19015577Medicaid
IN000000915767OtherBCBS ONCOLOGY
WY146945200Medicaid
IN000000915765OtherBCBS BMG HEMATOLOGY
IN200814380AMedicaid
IN216950CMedicare PIN
IN000000915765OtherBCBS BMG HEMATOLOGY
IN200814380AMedicaid