Provider Demographics
NPI:1003431628
Name:QUENTIN, MERCY TASIAME
Entity Type:Individual
Prefix:
First Name:MERCY
Middle Name:TASIAME
Last Name:QUENTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MERCY
Other - Middle Name:
Other - Last Name:TASIAME
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:UNIQUE CARES
Mailing Address - Street 1:7310 UNITY LANE NORTH
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443
Mailing Address - Country:US
Mailing Address - Phone:612-460-7680
Mailing Address - Fax:
Practice Address - Street 1:7310 UNITY LANE NORTH
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443
Practice Address - Country:US
Practice Address - Phone:612-460-7680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251E00000X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No251E00000XAgenciesHome Health