Provider Demographics
NPI:1942532353
Name:QUILICI, SUZANNE (APN)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:QUILICI
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 W ANN ST
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-3901
Mailing Address - Country:US
Mailing Address - Phone:775-885-2211
Mailing Address - Fax:
Practice Address - Street 1:900 E LONG ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-3129
Practice Address - Country:US
Practice Address - Phone:775-887-2190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV09778163WC1500X
NV00070163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health