Look up the most recent NPI and PECOS records

Kimberly Proto-Conroy

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

4500 San Pablo Rd S Bldg 7th, Jacksonville, FL 32224-1865

(904) 953-2000

PECOS Enrollment

Based on the most recent information from CMS, provider Kimberly Proto-Conroy does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 8 days ago.

Profile Details

Provider ID
1215033576
Provider Type
Individual
Full Name
Proto-Conroy, Kimberly
Credential
APRN

Gender
Female
Sole Proprietor
No
Enumeration Date
9/15/2006
Last Updated
1/13/2023

Contact Information

Practice Location

4500 San Pablo Rd S Bldg 7th, Jacksonville, FL 32224-1865

(904) 953-2000

Unlisted Fax

Mailing Location

4500 San Pablo Rd S, Jacksonville, FL 32224-1865

(904) 953-2000

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License APRN9491931 Florida
Code 363L00000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 442971 New York

Provider Identifiers

ID	Description	Issuer
ID P019302243	Description Other	Issuer BLUE CHOICE New York

Kimberly Proto-Conroy

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Neeson, Lynn

Molenaar, Michelle Lynn

Myatt, Kaitlin Marie

Dehr, Lindsay Mychael

Mattingly, Jessica

Sheridan-Young, Jean

Prussak, Karin

Ayer, Faith Elizabeth

Laroche, Kaley A

Mucha, Jennifer Shay