Provider Demographics
NPI:1801374681
Name:KONKEL, MARY THORNTON (ARNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:THORNTON
Last Name:KONKEL
Suffix:
Gender:F
Credentials:ARNP
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Mailing Address - Street 1:PO BOX 100237
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0237
Mailing Address - Country:US
Mailing Address - Phone:352-273-5159
Mailing Address - Fax:352-273-5213
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610
Practice Address - Country:US
Practice Address - Phone:352-273-5159
Practice Address - Fax:352-273-5213
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2022-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN9189853363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner