Provider Demographics
NPI:1679907620
Name:QUIGLEY, NANCY JOAN (LMT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:JOAN
Last Name:QUIGLEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12151 ELM FOREST CT
Mailing Address - Street 2:UNIT M
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-6306
Mailing Address - Country:US
Mailing Address - Phone:702-575-0729
Mailing Address - Fax:301-540-4615
Practice Address - Street 1:12151 ELM FOREST CT
Practice Address - Street 2:UNIT M
Practice Address - City:CLARKSBURG
Practice Address - State:MD
Practice Address - Zip Code:20871-6306
Practice Address - Country:US
Practice Address - Phone:702-575-0729
Practice Address - Fax:301-540-4615
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR01749246Z00000X, 2471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography