Provider Demographics
NPI:1679852768
Name:QUINN-FREEMAN, LASAGNA (ARNP)
Entity Type:Individual
Prefix:
First Name:LASAGNA
Middle Name:
Last Name:QUINN-FREEMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 HIGHWAY 34 E
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-1323
Mailing Address - Country:US
Mailing Address - Phone:770-304-3724
Mailing Address - Fax:706-576-5150
Practice Address - Street 1:1425 HIGHWAY 34 E
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-1323
Practice Address - Country:US
Practice Address - Phone:770-304-3724
Practice Address - Fax:770-304-3726
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN186321363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner