Provider Demographics
NPI:1487813135
Name:CONRAD, STEPHANIE JOHNS (MD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JOHNS
Last Name:CONRAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:LYNN
Other - Last Name:JOHNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5121 DOCTORS OFFICE TOWER
Mailing Address - Street 2:2200 CHILDREN'S WAY
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-9075
Mailing Address - Country:US
Mailing Address - Phone:615-936-1302
Mailing Address - Fax:615-936-3467
Practice Address - Street 1:5121 DOCTORS OFFICE TOWER
Practice Address - Street 2:2200 CHILDREN'S WAY
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-9075
Practice Address - Country:US
Practice Address - Phone:615-936-1302
Practice Address - Fax:615-936-3467
Is Sole Proprietor?:No
Enumeration Date:2008-06-07
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN524942080P0203X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics