Provider Demographics
NPI:1073730073
Name:QUINLAN, COLLEEN M (WHCNP)
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:M
Last Name:QUINLAN
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-5838
Mailing Address - Country:US
Mailing Address - Phone:419-255-1115
Mailing Address - Fax:419-255-2500
Practice Address - Street 1:1301 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-5838
Practice Address - Country:US
Practice Address - Phone:419-255-1115
Practice Address - Fax:419-255-2500
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP02197363LW0102X
OHRN270881163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2016722Medicaid
OH2016722Medicaid
OHH210590Medicare PIN
OHNP06892Medicare ID - Type Unspecified