Organization
KATE CONKLIN, REGISTERED DIETITIAN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATE CONKLIN MS, RDN, LDN (REGISTERED DIETITIAN)
(860) 833-7162
Entity
Organization
Contact information
Practice address
321 1ST ST, BLAKELY, PA 18447-1205
(860) 833-7162
Mailing address
321 1ST ST, BLAKELY, PA 18447-1205
(860) 833-7162
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN007174
PENNSYLVANIA BOARD OF NURSING
PA
Enumeration date
03/04/2021
Last updated
03/04/2021
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