Provider Demographics
NPI:1932513314
Name:DUNCAN, QUIANA (NP)
Entity Type:Individual
Prefix:
First Name:QUIANA
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-4358
Mailing Address - Country:US
Mailing Address - Phone:704-874-1904
Mailing Address - Fax:704-867-2134
Practice Address - Street 1:119 W PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:BESSEMER CITY
Practice Address - State:NC
Practice Address - Zip Code:28016-2635
Practice Address - Country:US
Practice Address - Phone:704-629-4365
Practice Address - Fax:704-629-1355
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-13
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006928363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1932513314Medicaid
SCNP3676Medicaid
SCNP3676Medicaid
NC1932513314Medicaid
NCNCJ034BMedicare PIN
NCNCJ034CMedicare PIN