Provider Demographics
NPI:1093468795
Name:KEESECKER, QUINCIE (APRN-C)
Entity Type:Individual
Prefix:
First Name:QUINCIE
Middle Name:
Last Name:KEESECKER
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2331 TUTTLE CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-4462
Mailing Address - Country:US
Mailing Address - Phone:785-537-4940
Mailing Address - Fax:785-537-0836
Practice Address - Street 1:2331 TUTTLE CREEK BLVD
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-4462
Practice Address - Country:US
Practice Address - Phone:785-537-4940
Practice Address - Fax:785-537-0836
Is Sole Proprietor?:No
Enumeration Date:2022-02-02
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-80882-122363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily