Provider Demographics
NPI:1235565839
Name:QUITIQUIT, ALVIN (LPN)
Entity Type:Individual
Prefix:
First Name:ALVIN
Middle Name:
Last Name:QUITIQUIT
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 L ST NW STE 900
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-4208
Mailing Address - Country:US
Mailing Address - Phone:202-829-1111
Mailing Address - Fax:202-829-9192
Practice Address - Street 1:1707 L ST NW STE 900
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-4208
Practice Address - Country:US
Practice Address - Phone:202-829-1111
Practice Address - Fax:202-829-9192
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLPN1007441164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse