Provider Demographics
NPI:1578718318
Name:QUINN, JOSHUA M (RD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:M
Last Name:QUINN
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 LOS ALTOS PKWY APT 154
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-7680
Mailing Address - Country:US
Mailing Address - Phone:775-830-2276
Mailing Address - Fax:775-622-4371
Practice Address - Street 1:1500 E 2ND ST
Practice Address - Street 2:STE 402
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1262
Practice Address - Country:US
Practice Address - Phone:775-982-5073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00967937133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered