Provider Demographics
NPI:1205235215
Name:CONKWRIGHT, CAROLINE (PA-C)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:CONKWRIGHT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:5589 N CROATAN HWY
Practice Address - Street 2:
Practice Address - City:KITTY HAWK
Practice Address - State:NC
Practice Address - Zip Code:27949-3996
Practice Address - Country:US
Practice Address - Phone:252-715-0610
Practice Address - Fax:252-715-0612
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2021-09-14
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant