Provider Demographics
NPI:1417653023
Name:QUINTANILLA, BRIDGET SALINA (FNP-S)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:SALINA
Last Name:QUINTANILLA
Suffix:
Gender:F
Credentials:FNP-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 E 3950 S
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780-3023
Mailing Address - Country:US
Mailing Address - Phone:435-592-6878
Mailing Address - Fax:
Practice Address - Street 1:934 E 3950 S
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780-3023
Practice Address - Country:US
Practice Address - Phone:435-592-6878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT363LP2300X363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care