Individual
ELIJAH TYLER MCCONKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3755 N 38TH ST, OMAHA, NE 68111-2617
(646) 360-9738
Mailing address
3755 N 38TH ST, OMAHA, NE 68111-2617
(646) 360-9738
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0337025
CO
Other
Enumeration date
11/18/2024
Last updated
11/18/2024
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