Provider Demographics
NPI:1932464617
Name:QUINN, NICOLE E (MD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:E
Last Name:QUINN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1267 HIGHWAY 54 W STE 3200
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-2111
Mailing Address - Country:US
Mailing Address - Phone:770-632-9900
Mailing Address - Fax:770-632-9997
Practice Address - Street 1:1267 HIGHWAY 54 W STE 3200
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-2111
Practice Address - Country:US
Practice Address - Phone:770-632-9900
Practice Address - Fax:770-632-9997
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA076422207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology