Provider Demographics
NPI:1679145304
Name:CONATSER, BRIANNA SKY
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:SKY
Last Name:CONATSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 INTEGRITY WAY UNIT 106
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-3855
Mailing Address - Country:US
Mailing Address - Phone:502-593-3142
Mailing Address - Fax:
Practice Address - Street 1:1908 INTEGRITY WAY UNIT 106
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-3855
Practice Address - Country:US
Practice Address - Phone:502-593-3142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator