Provider Demographics
NPI:1568242683
Name:MCQUONE, JUSTINA JEAN
Entity Type:Individual
Prefix:
First Name:JUSTINA
Middle Name:JEAN
Last Name:MCQUONE
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 1:3914 SUMMIT RD
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-3509
Mailing Address - Country:US
Mailing Address - Phone:330-281-2611
Mailing Address - Fax:
Practice Address - Street 1:3914 SUMMIT RD
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-3509
Practice Address - Country:US
Practice Address - Phone:330-281-2611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health