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Individual
ALISSA MARIE CONKLIN
Active
Individual
ALISSA MARIE CONKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01067822A
IN
207V00000X
Obstetrics & Gynecology Physician
11014262A
IN
207V00000X
Obstetrics & Gynecology Physician
4301104200
MI
207V00000X
Obstetrics & Gynecology Physician
MD60198764
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001526215
ANTHEM PTAN
IN
05
—
300048049
—
IN
Enumeration date
06/09/2008
Last updated
07/25/2025
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