MRS. NICOLE CONKLING (NPI# 1053602763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053602763 |
| Entity Type | Individual |
| Full Name | MRS. NICOLE CONKLING |
| Other Name | NICOLE DIONE GOVIGNON |
| Credential | CRNP |
| Practice Address |
1407 York Rd Timonium MD 21093 |
| Mailing Address |
508 Whithorn Ct Lutherville MD 21093-7026 |
| Practice Telephone | 4107468342 |
| Mailing Telephone | 4107468342 |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2019-11-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
R172502 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
R172502 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
R172502 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1407 York Rd, Timonium, MD 21093 | 4107468342 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477895779 | Nicole Conkling | Student in an Organized Health Care Education/Training Program | Ucsf Department of Surgery, 513 Parnassus Avenue, S-321, San Francisco, CA 94143-0470 | 2013-03-25 |
| Street Address |
1407 YORK RD |
| City | TIMONIUM |
| State | MD |
| Zip Code | 21093 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497309959 | Megan Lagergren | Social Worker | 1407 York Rd. Suite 307, Baltimore, MD 21093 | 2019-08-01 |
| 1437629003 | Mary Ann Lopus | Counselor | Villa Maria School 2300 Dulaney Valley Road, Timonium, MD 21093 | 2018-11-27 |
| 1275001455 | Hannah Michele Breckenridge | Social Worker | 1212 York Rd Ste A302, Lutherville, MD 21093 | 2018-11-06 |
| 1386111573 | Christina Calabrese | Social Worker | Villa Maria School, 2300 Dulaney Valley Road, Timonium, MD 21093 | 2018-10-26 |
| 1790279735 | Synopsis Healthscience | Internal Medicine | 19 Huntress Ct, Timonium, MD 21093 | 2018-06-21 |
| 1134648629 | Centers for Advanced Orthopaedics, LLC | Occupational Therapist | 1312 Bellona Ave Ste 302, Lutherville, MD 21093 | 2017-09-15 |
| 1134647746 | Andrea Stokes Rackowski | Social Worker | 1400 Front Ave. Suite 305, Lutherville, MD 21093 | 2017-09-03 |
| 1790200780 | Judson Franklin Force Jr. | Pediatrics | 309 Overlook Dr, Timonium, MD 21093 | 2017-08-10 |
| 1942722053 | Eundae Suk | Chiropractor | 1407 York Rd Ste 302, Lutherville, MD 21093 | 2017-07-10 |
| 1508301482 | Bh Brightview Mays Chapel Ridge Opco, LLC | Alzheimer Center (Dementia Center) | 12261 Roundwood Road, Timonium, MD 21093 | 2016-12-30 |
| Find all providers in zip 21093 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225384431 | Tammy Acker | Nurse Practitioner | 1931 Greenspring Drive, Timonium, MD 21093 | 2012-07-25 |
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|---|---|---|---|---|
| 1821697533 | Brighter Days Recovery Center | Nurse Practitioner | 2439 E Lafayette Ave, Baltimore, MD 21213-2562 | 2020-10-23 |
| 1033718762 | White Plains Primary Care | Nurse Practitioner | 50 Post Office Rd Ste 304, Waldorf, MD 20602-3704 | 2020-10-23 |
| 1245839653 | Itoro Abatai | Nurse Practitioner | 9620 Maxwell Rd, Middle River, MD 21220-3792 | 2020-10-19 |
| 1992304372 | Catherine Koskei | Nurse Practitioner | 2295 Lowell Ridge Rd Apt B, Parkville, MD 21234-2370 | 2020-10-18 |
| 1194323857 | Meliora Davies | Nurse Practitioner | 206 Settlers Way, Upper Marlboro, MD 20774-5770 | 2020-10-14 |
| 1932707171 | David Mwangi | Nurse Practitioner | 27 Blue Spire Cir, Middle River, MD 21220-1743 | 2020-10-10 |
| 1750989042 | Osereme Nora Agboifo | Nurse Practitioner | 200 Ejoppa Rd Suite 106, Townson, MD 21286 | 2020-10-09 |
| 1639776446 | Serenity Heart Healthcare, LLC | Nurse Practitioner | 6755 Business Pkwy Ste 304, Elkridge, MD 21075-6740 | 2020-10-05 |
| 1689281529 | Premier Psychiatry, LLC | Nurse Practitioner | 10601 Virginia Ave, Cockeysville, MD 21030-2315 | 2020-09-24 |
| 1407462559 | Mem Scepter Home & Behavioral | Nurse Practitioner | 14104 Dawn Whistle Way, Bowie, MD 20721-1304 | 2020-09-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.