Provider Demographics
NPI:1669161774
Name:QUINONES, SARAH LYNN
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:LYNN
Last Name:QUINONES
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 1:324 3RD ST SE
Mailing Address - Street 2:
Mailing Address - City:DEVILS LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58301-3603
Mailing Address - Country:US
Mailing Address - Phone:701-516-2300
Mailing Address - Fax:
Practice Address - Street 1:7944 39TH ST NE
Practice Address - Street 2:
Practice Address - City:SAINT MICHAEL
Practice Address - State:ND
Practice Address - Zip Code:58370-9009
Practice Address - Country:US
Practice Address - Phone:701-766-4315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant