Provider Demographics
NPI:1841237781
Name:O'QUINN, KIRSTEN L (MD)
Entity Type:Individual
Prefix:DR
First Name:KIRSTEN
Middle Name:L
Last Name:O'QUINN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:W178N9912 RIVERCREST DR STE 105
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53022-4662
Mailing Address - Country:US
Mailing Address - Phone:262-682-8810
Mailing Address - Fax:262-432-7183
Practice Address - Street 1:W178N9912 RIVERCREST DR STE 105
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:WI
Practice Address - Zip Code:53022
Practice Address - Country:US
Practice Address - Phone:262-682-8810
Practice Address - Fax:262-432-7183
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2019-08-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI45885207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34637100Medicaid
WI1841237781Medicaid
WI34637100Medicaid