Individual
MS. DIANE CONKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2180 MAIN ST, WAILUKU, HI 96793-1666
(808) 242-6464
(808) 242-4209
Mailing address
2180 MAIN ST, WAILUKU, HI 96793-1666
(808) 242-6464
(808) 242-4209
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN827
HI
363LP2300X
Primary Care Nurse Practitioner
Primary
201703379NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0257493
HMSA - 65CP - HMSA QUEST
HI
01
—
431043
UHA
HI
01
—
99017685996768
TRICARE- CHAMPUS
HI
Enumeration date
07/08/2006
Last updated
05/30/2017
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