Provider Demographics
NPI:1811685209
Name:CONKEL, TAYLOR (BSN, RNC-MNN, IBCLC)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:CONKEL
Suffix:
Gender:F
Credentials:BSN, RNC-MNN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 WILMA ST
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-5644
Mailing Address - Country:US
Mailing Address - Phone:903-805-0233
Mailing Address - Fax:
Practice Address - Street 1:1217 WILMA ST
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-5644
Practice Address - Country:US
Practice Address - Phone:903-805-0233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX899812163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant