Provider Demographics
NPI:1205596236
Name:QUINTANA, MEGAN L
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:L
Last Name:QUINTANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 E WILLIAM ST STE 435
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-3199
Mailing Address - Country:US
Mailing Address - Phone:775-684-3693
Mailing Address - Fax:
Practice Address - Street 1:1050 E WILLIAM ST STE 435
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-3199
Practice Address - Country:US
Practice Address - Phone:775-684-3693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-17
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1234567253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care