Individual provider · Type 1 NPI

Mary Jack Conklin, NP

Gerontology Nurse Practitioner · Walnut Creek, CA

NPI number 1366526840 Active

Practice location

1425 S Main St, Mob 3rd Floor Surgery Clinic
Walnut Creek, CA 94596-5318

Specialties and licenses

TaxonomyCodeLicense
Gerontology Nurse Practitioner Primary 363LG0600X302434 (CA)

Gerontology Nurse Practitioner: Definition to come...

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About NPI 1366526840

Mary Jack Conklin, NP's National Provider Identifier is 1366526840, issued on Oct 24, 2006. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Walnut Creek, CA. The record was last updated on Jul 8, 2007.