Provider Demographics
NPI:1437407368
Name:QUAIN, CAROL ANNETTE (FNP-C)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANNETTE
Last Name:QUAIN
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 1:175 TIMBERLANE DR
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-0600
Mailing Address - Country:US
Mailing Address - Phone:276-206-4526
Mailing Address - Fax:
Practice Address - Street 1:4381 S EASON BLVD STE 202
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6585
Practice Address - Country:US
Practice Address - Phone:662-377-6609
Practice Address - Fax:662-377-6614
Is Sole Proprietor?:No
Enumeration Date:2012-08-27
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR871939363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily