Provider Demographics
NPI:1689851289
Name:QUINN, THOMAS E (APRN, MSN)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:E
Last Name:QUINN
Suffix:
Gender:M
Credentials:APRN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17876 SAINT CLAIR AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110-2602
Mailing Address - Country:US
Mailing Address - Phone:216-383-2222
Mailing Address - Fax:216-298-0241
Practice Address - Street 1:17876 SAINT CLAIR AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44110-2602
Practice Address - Country:US
Practice Address - Phone:216-383-2222
Practice Address - Fax:216-298-0241
Is Sole Proprietor?:No
Enumeration Date:2008-01-25
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH378279364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist