| Doctor Name: | MRS. KELSEY MARIE CONKLIN |
| NPI Number: | 1801255120 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, FNP |
| License Number: | 201041816RN |
| Business Practice Address: | 1375 N 10th Ave Stayton, OR - 973832099 |
| Business Phone Number: | 5037692641 |
| Business Fax Number: | |
| Mailing Address: | 1375 N 10th Ave, STAYTON |
| State: | OR |
| Postal Code: | 973832099 |
| Phone Number: | 5037692641 |
| Fax Number: | |
| NPI Enumeration Date: | 02/15/2016 |
| NPI Last Update Date: | 04/01/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WE0003X |
| License Number: | 201041816RN |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OR |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Emergency |
| Taxonomy Definition: | |