Individual
EMILY CONKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3800 S NATIONAL AVE, SPRINGFIELD, MO 65807-5209
(417) 875-3845
Mailing address
PO BOX 9007, SPRINGFIELD, MO 65808-9007
(417) 875-3846
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2019011713
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912561135
—
MO
Enumeration date
04/23/2019
Last updated
04/05/2024
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