Provider Demographics
NPI:1083212302
Name:QUINNESSENTIAL HEALTHCARE
Entity Type:Organization
Organization Name:QUINNESSENTIAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIUS
Authorized Official - Middle Name:SEECE
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:316-364-4100
Mailing Address - Street 1:8100 E 22ND ST N STE 100-6
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2301
Mailing Address - Country:US
Mailing Address - Phone:316-364-4100
Mailing Address - Fax:316-364-4101
Practice Address - Street 1:8100 E 22ND ST N STE 100-6
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2301
Practice Address - Country:US
Practice Address - Phone:316-364-4100
Practice Address - Fax:316-364-4101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-09
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS78511OtherKS LICENSE