Provider Demographics
NPI:1508296476
Name:RANSON, QUINN DONALD (PA-C)
Entity Type:Individual
Prefix:MR
First Name:QUINN
Middle Name:DONALD
Last Name:RANSON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:703 RIGBY LAKE DR
Mailing Address - Street 2:
Mailing Address - City:RIGBY
Mailing Address - State:ID
Mailing Address - Zip Code:83442-5192
Mailing Address - Country:US
Mailing Address - Phone:208-745-0200
Mailing Address - Fax:208-745-0212
Practice Address - Street 1:703 RIGBY LAKE DR
Practice Address - Street 2:
Practice Address - City:RIGBY
Practice Address - State:ID
Practice Address - Zip Code:83442-5192
Practice Address - Country:US
Practice Address - Phone:208-745-0200
Practice Address - Fax:208-745-0212
Is Sole Proprietor?:No
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDPA-1120363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant