Provider Demographics
NPI:1437730140
Name:QUANTY, JOELLEN MARGARET
Entity Type:Individual
Prefix:
First Name:JOELLEN
Middle Name:MARGARET
Last Name:QUANTY
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 1:3925 PORTSMOUTH BLVD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-3624
Mailing Address - Country:US
Mailing Address - Phone:757-760-3035
Mailing Address - Fax:
Practice Address - Street 1:3925 PORTSMOUTH BLVD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-3624
Practice Address - Country:US
Practice Address - Phone:757-760-3035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024187618363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily