Individual
KATHERINE R CONKLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
4941 BENCHMARK CENTRE DR STE 100, SWANSEA, IL 62226-2038
(618) 624-9970
(618) 624-9973
Mailing address
4941 BENCHMARK CENTRE DR STE 100, SWANSEA, IL 62226-2038
(618) 624-9970
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209019444
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209019444
ADVANCED PRACTICE REGISTERED NURSE
IL
Enumeration date
05/29/2019
Last updated
05/29/2019
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