TRACY CONKLIN


Address: 1100 Gateway Ct, West Bend, WI 53095-8539
Phone: 2623358669

TRACY CONKLIN (NPI# 1437614765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 163WC3500X Registered Nurse
Specialization: Cardiac Rehabilitation
130714-30 WI Nursing Service Providers

Office Location

Street Address 1100 GATEWAY CT
City WEST BEND
State WI
Zip Code 53095-8539

Providers in the same location

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
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1508230632 Jesen Daniel Counselor 111 East Washington St, Affiliated Clinical Services, West Bend, WI 53095 2015-12-01
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Taxonomy Information

Taxonomy Code 163WC3500X
Grouping Nursing Service Providers
Classification Registered Nurse
Specialization Cardiac Rehabilitation

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

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

Competitor

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City WEST BEND
Zip Code 53095

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Dataset Information

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.

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