Provider Demographics
NPI:1831601038
Name:QUATTRONE, IANNA LIZBETH (PNP)
Entity type:Individual
Prefix:
First Name:IANNA
Middle Name:LIZBETH
Last Name:QUATTRONE
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2370 WALTON BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-1471
Mailing Address - Country:US
Mailing Address - Phone:248-651-8197
Mailing Address - Fax:248-651-5643
Practice Address - Street 1:1816 RICHARDSON DR
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-5434
Practice Address - Country:US
Practice Address - Phone:336-634-3902
Practice Address - Fax:336-634-3933
Is Sole Proprietor?:No
Enumeration Date:2017-10-27
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5011336363LP0200X
MI4704290304363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics