Provider Demographics
NPI:1376520189
Name:QUINN, CATHERINE K (MS,RD,LD)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:K
Last Name:QUINN
Suffix:
Gender:F
Credentials:MS,RD,LD
Other - Prefix:MRS
Other - First Name:CATHERINE
Other - Middle Name:K
Other - Last Name:OLIVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,RD,LD
Mailing Address - Street 1:4950 CHILDREN'S PL
Mailing Address - Street 2:MS 90-21-342
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110
Mailing Address - Country:US
Mailing Address - Phone:314-362-4517
Mailing Address - Fax:314-362-6959
Practice Address - Street 1:4950 CHILDREN'S PL
Practice Address - Street 2:MS 90-21-342
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110
Practice Address - Country:US
Practice Address - Phone:314-362-4517
Practice Address - Fax:314-362-6959
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001027042133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered