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General NPI Number Information
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NPI Number | 1942802269
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Entity Type | Individual
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Provider Name | JENNIFER LYNN CONKLIN PHARM.D., RPH
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Gender | Female
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Dates
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Enumeration Date | 11/11/2020
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Last Update Date | 11/11/2020
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Provider Practice Location Address
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Address Line | 4141 PEARL RD
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City | MEDINA
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State | OH
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Zip | 44256-7649
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Country | US
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Telephone | 330-723-1511
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Fax |
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Provider Business Mailing Address
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Address Line | 7646 RIMROCK RD
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City | MEDINA
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State | OH
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Zip | 44256-6205
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Country | US
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Telephone | 440-554-6370
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03331597
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License Number State | OH
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