Provider Demographics
NPI:1427190511
Name:QUINN, NANCY JANE (NP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:JANE
Last Name:QUINN
Suffix:
Gender:F
Credentials:NP
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Other - Last Name:
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Mailing Address - Street 1:875 BLAKE WILBUR DRIVE
Mailing Address - Street 2:ROOM 1205 MAIL CODE 5820
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-5826
Mailing Address - Country:US
Mailing Address - Phone:650-725-5458
Mailing Address - Fax:650-723-0765
Practice Address - Street 1:875 BLAKE WILBUR DRIVE
Practice Address - Street 2:ROOM 1205 MAIL CODE 5820
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-5826
Practice Address - Country:US
Practice Address - Phone:650-725-5458
Practice Address - Fax:650-723-0765
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP766363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS51304Medicare UPIN