Provider Demographics
NPI:1144588716
Name:QUIRANTE, ROSE E (MS RD LD)
Entity Type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:E
Last Name:QUIRANTE
Suffix:
Gender:F
Credentials:MS RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 BLACKBERRY LN
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-7207
Mailing Address - Country:US
Mailing Address - Phone:409-722-4067
Mailing Address - Fax:409-722-4067
Practice Address - Street 1:4000 BLACKBERRY LN
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-7207
Practice Address - Country:US
Practice Address - Phone:409-722-4067
Practice Address - Fax:409-722-4067
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT00378133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered