Provider Demographics
NPI:1174660849
Name:QUINLAN, NANCY ANN (CRNA)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ANN
Last Name:QUINLAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 28TH ST SW
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-6416
Mailing Address - Country:US
Mailing Address - Phone:641-201-1638
Mailing Address - Fax:641-424-6709
Practice Address - Street 1:1000 4TH ST SW
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2800
Practice Address - Country:US
Practice Address - Phone:641-428-7108
Practice Address - Fax:641-428-7088
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL074062367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN430076177OtherRR MEDICARE
MN430076177OtherRR MEDICARE