Conkling, Katherine R

Conkling, Katherine R is an individual health care provider with primary practice located at 4941 Benchmark Centre Dr Ste 100 , Swansea IL 62226-2038. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Conkling, Katherine R can be contacted via phone (618) 624-9970.

Contact Information

Primary practice address
4941 Benchmark Centre Dr Ste 100 Swansea IL 62226-2038
Phone: (618) 624-9970
Fax: (618) 624-9973
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 209019444 Illinois

Profile Details

NPI number 1841858529
LBN Legal business name Conkling, Katherine R
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 29th, 2019
Last updated May 29th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841858529 NPPES
Illinois Other 209019444 ADVANCED PRACTICE REGISTERED NURSE

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