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Individual

EVELYN COLLEEN CONKLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS-RN

Contact information

Practice address
43835 BRANDYWYNE RD, CANTON, MI 48187-2158
(734) 459-8991
Mailing address
43835 BRANDYWYNE RD, CANTON, MI 48187-2158
(734) 459-8991

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
4704080542
MI
163WP0808X
Psychiatric/Mental Health Registered Nurse
4704080542
MI
364S00000X
Clinical Nurse Specialist
Primary
4704080542
MI

Other

Enumeration date
02/07/2008
Last updated
07/18/2013
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