Conklin, Lorraine

Conklin, Lorraine is an individual health care provider with primary practice located at 7333 W Jefferson Blvd , Fort Wayne IN 46804-6280. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Conklin, Lorraine can be contacted via phone (260) 435-7334.

Contact Information

Primary practice address
7333 W Jefferson Blvd Fort Wayne IN 46804-6280
Phone: (260) 435-7334
Fax: (260) 435-7748
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 10000299A Indiana

Profile Details

NPI number 1619915188
LBN Legal business name Conklin, Lorraine
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 4th, 2006
Last updated Sep 16th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619915188 NPPES
Indiana Other 668020U MEDICARE ID

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