Lori Jean Conlin, Nurse Practitioner
Nurse Practitioner in Port Jefferson Station, NY. Individual provider (NPI-1).
NPI number1114081239
StatusActive
Last updated in NPPESSep 14, 2023
Details
- NPI
- 1114081239
- Entity type
- Individual (NPI-1)
- Name
- Lori Jean Conlin
- Credential
- Nurse Practitioner
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 21, 2006
- Certification date
- Sep 14, 2023
- Last updated
- Sep 14, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | F302381 | NY | Yes |
Practice location
5316 Nesconset HwyPort Jefferson Station, NY 11776-2591
Phone 316-897-8006 · Fax 631-751-0506
Mailing address
6 Knollwood LaneSmithtown, NY 11787
Phone 631-543-7813
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