Provider Demographics
NPI:1417565466
Name:QUINONES, CIARA SHANTE
Entity Type:Individual
Prefix:MS
First Name:CIARA
Middle Name:SHANTE
Last Name:QUINONES
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 1:7642 PINEDALE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-4829
Mailing Address - Country:US
Mailing Address - Phone:803-862-6677
Mailing Address - Fax:
Practice Address - Street 1:7642 PINEDALE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-4829
Practice Address - Country:US
Practice Address - Phone:803-862-6677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide