Provider Demographics
NPI:1801577077
Name:STETLER, QUINN (RN)
Entity type:Individual
Prefix:
First Name:QUINN
Middle Name:
Last Name:STETLER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1267 JONES TRL
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-2528
Mailing Address - Country:US
Mailing Address - Phone:715-645-2341
Mailing Address - Fax:
Practice Address - Street 1:1267 JONES TRL
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077-2528
Practice Address - Country:US
Practice Address - Phone:715-645-2341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX957461163WN1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN1003XNursing Service ProvidersRegistered NurseNutrition Support