Provider Demographics
NPI:1417206657
Name:QUINN, AMY L (FNP-C)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:QUINN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6073 S ZENO CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-1178
Mailing Address - Country:US
Mailing Address - Phone:303-880-0651
Mailing Address - Fax:
Practice Address - Street 1:29270 EAST SMOKY HILL ROAD
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015
Practice Address - Country:US
Practice Address - Phone:303-680-0664
Practice Address - Fax:303-693-2043
Is Sole Proprietor?:No
Enumeration Date:2012-09-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN0990462363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
F0712440OtherFNP CERTIFICATION
CO84428724Medicaid