Provider Demographics
NPI:1255392932
Name:QUINN, EILEEN M (NP)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:M
Last Name:QUINN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:EILEEN
Other - Middle Name:M
Other - Last Name:QUINN-SINCLAIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:147 MILK ST
Mailing Address - Street 2:PROVIDER ENROLLMENT - 9TH FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-4806
Mailing Address - Country:US
Mailing Address - Phone:617-559-8374
Mailing Address - Fax:617-421-3487
Practice Address - Street 1:254 SECOND AVE
Practice Address - Street 2:ATRIUS HEALTH, INC. - ECF AND IHB PROGRAMS
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494
Practice Address - Country:US
Practice Address - Phone:617-421-2686
Practice Address - Fax:617-983-4446
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA107439363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0389391Medicaid
MANP2337OtherBLUE CROSS
MAC423OtherHARVARD PILGRIM
MAC423OtherHARVARD PILGRIM
MANP2337Medicare ID - Type Unspecified