Provider Demographics
NPI:1194454744
Name:QUINLAN, KARLY
Entity Type:Individual
Prefix:
First Name:KARLY
Middle Name:
Last Name:QUINLAN
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 1:8210 KEENELAND CT
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-9154
Mailing Address - Country:US
Mailing Address - Phone:513-418-1782
Mailing Address - Fax:
Practice Address - Street 1:8210 KEENELAND CT
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-9154
Practice Address - Country:US
Practice Address - Phone:513-418-1782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker