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General NPI Number Information
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NPI Number | 1235902438
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Entity Type | Organization
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Legal Business Name | CONQUEST HEALTH
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Dates
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Enumeration Date | 10/31/2023
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 7110 HERITAGE VILLAGE PLZ STE 101
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City | GAINESVILLE
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State | VA
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Zip | 20155-3076
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Country | US
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Telephone | 571-556-8205
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Fax | 833-428-8384
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Provider Business Mailing Address
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Address Line | 7110 HERITAGE VILLAGE PLZ STE 101
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City | GAINESVILLE
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State | VA
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Zip | 20155-3076
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Country | US
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Telephone | 571-556-8205
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Fax | 833-428-8384
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAVID PHELPS
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Credential | APRN
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Telephone | 703-283-4215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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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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