Provider Demographics
NPI:1093437196
Name:QUIRK, RHIANNA ALLEY-MARIE
Entity Type:Individual
Prefix:
First Name:RHIANNA
Middle Name:ALLEY-MARIE
Last Name:QUIRK
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 1:1821 MARK TRL
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73141-4414
Mailing Address - Country:US
Mailing Address - Phone:405-876-3495
Mailing Address - Fax:
Practice Address - Street 1:1821 MARK TRL
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73141-4414
Practice Address - Country:US
Practice Address - Phone:405-876-3495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty