Provider Demographics
NPI:1922859768
Name:CONQUERINGBEAR, SARAH LEE
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LEE
Last Name:CONQUERINGBEAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 506
Mailing Address - Street 2:
Mailing Address - City:FORT TOTTEN
Mailing Address - State:ND
Mailing Address - Zip Code:58335-0506
Mailing Address - Country:US
Mailing Address - Phone:701-230-7685
Mailing Address - Fax:
Practice Address - Street 1:3742 LENIOR RD
Practice Address - Street 2:
Practice Address - City:ST MICHAELS
Practice Address - State:ND
Practice Address - Zip Code:58370
Practice Address - Country:US
Practice Address - Phone:701-230-7685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty