TRACY CONKLIN (NPI# 1437614765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1437614765 |
Entity Type | Individual |
Full Name | TRACY CONKLIN |
Credential | RN |
Practice Address |
1100 Gateway Ct West Bend WI 53095-8539 |
Mailing Address |
1137 Kinross Ct West Bend WI 53095-3825 |
Practice Telephone | 2623358669 |
Enumeration Date | 2019-01-31 |
Last Update Date | 2019-01-31 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 163WC3500X |
Registered Nurse Specialization: Cardiac Rehabilitation |
130714-30 | WI | Nursing Service Providers |
Street Address |
1100 GATEWAY CT |
City | WEST BEND |
State | WI |
Zip Code | 53095-8539 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346214897 | Ryszard Cholewa | Family Medicine | 1100 Gateway Ct, West Bend, WI 53095-8539 | 2006-02-13 |
1790292944 | Alissa M Straub | Occupational Therapist | 1100 Gateway Ct, West Bend, WI 53095-8539 | 2018-01-09 |
1225559321 | Abigail Jean Haag Davis | Nurse Practitioner | 1100 Gateway Ct, West Bend, WI 53095-8539 | 2017-06-29 |
1174998793 | Kyle Butters | Specialist/Technologist | 1100 Gateway Ct, West Bend, WI 53095-8539 | 2015-12-08 |
1801280177 | Omuwa Braimah | Family Medicine | 1100 Gateway Ct, West Bend, WI 53095 | 2015-03-25 |
1407269335 | Aurora Advanced Healthcare Inc | Durable Medical Equipment & Medical Supplies | 1100 Gateway Ct, West Bend, WI 53095-8539 | 2014-06-09 |
1396099479 | Abbey Mishica | Physical Therapy Assistant | 1100 Gateway Ct, West Bend, WI 53095-8539 | 2012-10-29 |
1174831150 | Allison R Sajdak Hetzel | Nurse Practitioner | 1100 Gateway Ct, West Bend, WI 53095-8539 | 2010-09-23 |
1194905273 | Nichole Carstens | Specialist/Technologist | 1100 Gateway Ct, West Bend, WI 53095-8539 | 2007-11-06 |
1689708976 | Jamie L Everts | Physical Therapist | 1100 Gateway Ct, West Bend, WI 53095 | 2007-03-16 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942820428 | David Fountain | Contractor | 726 Creedwood Lane, West Bend, WI 53095 | 2020-04-24 |
1922664358 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1745 South Main St, West Bend, WI 53095 | 2019-05-10 |
1912423773 | Michelle R Prentice | Family Medicine | West Bend Health Center, 1700 W. Paradise Drive, West Bend, WI 53095 | 2017-08-14 |
1386165918 | Quad/med, LLC | Clinic/Center | 432 E. Washington St. #1115, West Bend, WI 53095 | 2017-07-05 |
1508230632 | Jesen Daniel | Counselor | 111 East Washington St, Affiliated Clinical Services, West Bend, WI 53095 | 2015-12-01 |
1477965259 | Jenna Crofts | Specialist/Technologist | 1190 East Paradise Drive, West Bend, WI 53095 | 2014-05-28 |
1023436342 | Visionworks | Optometrist | 1437 S. Main St., West Bend, WI 53095 | 2014-04-03 |
1295157295 | Stephanie Rabe | Registered Nurse | 910 E. Paradise Drive, West Bend, WI 53095 | 2014-01-09 |
1477898815 | Ralph Norman Olsen | Pediatrics | 6267 Riesch Road, West Bend, WI 53095 | 2012-12-11 |
1932458536 | Joshua Aaron Barta | Dentist | 2090 Continental Drive, West Bend, WI 53095 | 2012-08-29 |
Find all providers in zip 53095 |
Taxonomy Code | 163WC3500X |
Grouping | Nursing Service Providers |
Classification | Registered Nurse |
Specialization | Cardiac Rehabilitation |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568927853 | Christine Garms | Registered Nurse | 1032 E Sumner St, Hartford, WI 53027-1608 | 2019-01-31 |
1548724966 | Pamela Sue Feucht | Registered Nurse | 1032 E Sumner St, Hartford, WI 53027-1608 | 2019-01-30 |
1457815870 | Heidi Marie Morgan | Registered Nurse | 1032 E Sumner St, Hartford, WI 53027-1608 | 2019-01-30 |
1922345370 | Sarah Sorenson | Registered Nurse | 1050 Division St, Mauston, WI 53948-1931 | 2013-01-04 |
1952647547 | Mary Elizabeth Marty | Registered Nurse | 1050 Division St, Mauston, WI 53948-1931 | 2012-12-31 |
1265799449 | Cynthia Lou Depies | Registered Nurse | 614 Memorial Dr, Chilton, WI 53014-1568 | 2012-04-12 |
1740553890 | Debra Schlough Koehnke | Registered Nurse | 1506 S Oneida St, Appleton, WI 54915-1305 | 2012-02-21 |
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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.