Provider Demographics
NPI:1326180944
Name:QUIRARTE, MARIA D
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:D
Last Name:QUIRARTE
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:PO BOX 17368
Mailing Address - Street 2:
Mailing Address - City:S LAKE TAHOE
Mailing Address - State:CA
Mailing Address - Zip Code:96151-7368
Mailing Address - Country:US
Mailing Address - Phone:530-318-8393
Mailing Address - Fax:
Practice Address - Street 1:1360 JOHNSON BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:S LAKE TAHOE
Practice Address - State:CA
Practice Address - Zip Code:96150-8220
Practice Address - Country:US
Practice Address - Phone:530-573-3142
Practice Address - Fax:530-541-8409
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide