Provider Demographics
NPI:1518038132
Name:MORTON-QUINN, LUGENE ANN (MS, RD, LDN)
Entity type:Individual
Prefix:
First Name:LUGENE
Middle Name:ANN
Last Name:MORTON-QUINN
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10105 FOX SQUIRREL DR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-3576
Mailing Address - Country:US
Mailing Address - Phone:727-858-4711
Mailing Address - Fax:
Practice Address - Street 1:5504 LITTLE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-1105
Practice Address - Country:US
Practice Address - Phone:727-858-4711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 2387133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU1186ZMedicare ID - Type Unspecified
FLU1186YMedicare ID - Type Unspecified