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General NPI Number Information
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NPI Number | 1447704705
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Entity Type | Individual
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Provider Name | SUSAN MCKENNA CONKLIN DNP
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Gender | Female
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Dates
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Enumeration Date | 08/04/2016
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 29 HOSPITAL PLZ STE 502
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City | STAMFORD
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State | CT
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Zip | 06902-3602
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Country | US
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Telephone | 203-276-8582
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Fax | 203-276-7382
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Provider Business Mailing Address
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Address Line | 29 HOSPITAL PLZ STE 502
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City | STAMFORD
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State | CT
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Zip | 06902-3602
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Country | US
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Telephone | 203-276-8582
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Fax | 203-276-7382
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 12.006624
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License Number State | CT
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