Evelyn Colleen Conklin, MS-RN

Primary specialty

Clinical Nurse SpecialistTaxonomy code 364S00000X

License

4704080542 Issued in MI

Practice address

43835 Brandywyne Rd
Canton, MI 48187-2158

Phone

(734) 459-8991

NPI assigned

Feb 7, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• E. Colleen Conklin Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1043498462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43835 BRANDYWYNE RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872158",
            "telephone_number": "734-459-8991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43835 BRANDYWYNE RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872158",
            "telephone_number": "734-459-8991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "EVELYN",
        "middle_name": "COLLEEN",
        "credential": "MS-RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-07",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "4704080542",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704080542",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "MI",
            "license": "4704080542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "E.",
            "last_name": "CONKLIN",
            "middle_name": "COLLEEN",
            "credential": "MS-RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Clinical Nurse Specialist in Canton, MI
• Providers in Canton, MI by specialty
• Clinical Nurse Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.