Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Kelly Renee Conklin, DNP

Individual provider Family Nurse Practitioner · NPI 1609893395

MS. Kelly Renee Conklin, DNP is a Nurse Practitioner in Roseburg, Oregon. Qualified in 1996, 30 years ago. Practices with Icco LLC, a 133-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
30
Licensed in
OR
In the registry since
2006
What do these letters mean?
DNP — Doctor of Nursing Practice
The highest clinical degree in nursing.

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Practice location Address checks out

913 NW Garden Valley Blvd
Roseburg, OR 97471
Phone: (541) 440-1000
Fax: (541) 440-1230
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 200450145NP (OR)

Record details

NPI number1609893395
Entity typeIndividual (Type 1)
GenderFemale
Credentials DNP
Sole proprietorNo
NPI enumeratedJuly 17, 2006
Last updated in NPPESFebruary 25, 2026
Certification dateFebruary 25, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Group practice Icco Llc — 133 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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