| Conquest Health Llc | |
|
12311 Snowden Woods Rd Laurel MD 20708-2492 | |
| (240) 603-1253 | |
| Not Available |
| Full Name | Conquest Health Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 12311 Snowden Woods Rd, Laurel, Maryland |
| Authorized Official Name and Position | Kumli S Anye (NURSE PRACTITIONER) |
| Authorized Official Contact | 2406031253 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conquest Health Llc 12311 Snowden Woods Rd Laurel MD 20708-2492 Ph: () - | Conquest Health Llc 12311 Snowden Woods Rd Laurel MD 20708-2492 Ph: (240) 603-1253 |
| NPI Number | 1043850415 |
|---|---|
| Provider Enumeration Date | 01/13/2020 |
| Last Update Date | 09/11/2021 |
| Medicare PECOS PAC ID | 9739500398 |
|---|---|
| Medicare Enrollment ID | O20200608000023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043850415 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 363LP2300X | Nurse Practitioner - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Kumli S Anye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104221613 PECOS PAC ID: 2961727847 Enrollment ID: I20160405002445 |
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