Provider Demographics
NPI:1023761939
Name:QUINN, ANDREW (AGACNP-BC)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:
Last Name:QUINN
Suffix:
Gender:M
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E 104TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-4517
Mailing Address - Country:US
Mailing Address - Phone:816-932-2836
Mailing Address - Fax:816-932-9868
Practice Address - Street 1:4320 WORNALL RD STE 530
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-5942
Practice Address - Country:US
Practice Address - Phone:816-932-2836
Practice Address - Fax:816-932-9868
Is Sole Proprietor?:No
Enumeration Date:2022-01-31
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014022787163W00000X
KS53-81058-071363LA2100X
MO2022017081363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse