Provider Demographics
NPI:1275894529
Name:QUINN, STACY (DO)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:QUINN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-2728
Mailing Address - Country:US
Mailing Address - Phone:540-564-7300
Mailing Address - Fax:757-431-7100
Practice Address - Street 1:1661 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-2728
Practice Address - Country:US
Practice Address - Phone:540-564-7300
Practice Address - Fax:757-431-7100
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-04
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS12721207Q00000X
VA0102206685207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine