Provider Demographics
NPI:1467518977
Name:QUAM, ALETHA KAY (RNCNP)
Entity Type:Individual
Prefix:MRS
First Name:ALETHA
Middle Name:KAY
Last Name:QUAM
Suffix:
Gender:F
Credentials:RNCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:18068 EVERGLADE CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55024-7021
Mailing Address - Country:US
Mailing Address - Phone:651-463-2558
Mailing Address - Fax:
Practice Address - Street 1:1801 W ALCOTT
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56538-0478
Practice Address - Country:US
Practice Address - Phone:218-332-5010
Practice Address - Fax:218-739-1329
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR057975-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health