Provider Demographics
NPI:1689289795
Name:QUINTELA, ADONIKA RAE
Entity Type:Individual
Prefix:
First Name:ADONIKA
Middle Name:RAE
Last Name:QUINTELA
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 1:8620 DUKE AVE
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79765-2106
Mailing Address - Country:US
Mailing Address - Phone:432-661-0705
Mailing Address - Fax:
Practice Address - Street 1:8620 DUKE AVE
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79765-2106
Practice Address - Country:US
Practice Address - Phone:432-661-0705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX982175163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse