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General NPI Number Information
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NPI Number | 1043004062
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Entity Type | Organization
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Legal Business Name | CONQUERED BALANCE
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Dates
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Enumeration Date | 04/07/2025
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 2506 COLLINGWOOD AVE
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City | SAGINAW
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State | MI
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Zip | 48601-3954
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Country | US
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Telephone | 989-780-4904
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 14754
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City | SAGINAW
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State | MI
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Zip | 48601-0754
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Country | US
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Telephone | 989-780-4904
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | ODESSHA YORK
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Credential | REGISTERED NURSE
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Telephone | 989-780-4904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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