Healthcare Provider Details

I. General information

NPI: 1982140885
Provider Name (Legal Business Name): CONQUER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2017
Last Update Date: 05/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9375 E SHEA BLVD STE 266
SCOTTSDALE AZ
85260
US

IV. Provider business mailing address

10820 N 127TH PL
SCOTTSDALE AZ
85259-4330
US

V. Phone/Fax

Practice location:
  • Phone: 480-652-2931
  • Fax:
Mailing address:
  • Phone: 480-652-2931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP5312
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberAP5312
License Number StateAZ

VIII. Authorized Official

Name: LOKESWARI BUCCHIREDDIGARI
Title or Position: OWNER/PROVIDER
Credential: MSN, FNP-C
Phone: 480-652-2931