Provider Demographics
NPI:1831605443
Name:CURRY, QUINTISA DEMEL (NP)
Entity type:Individual
Prefix:
First Name:QUINTISA
Middle Name:DEMEL
Last Name:CURRY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2581 SMITH LN
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-6599
Mailing Address - Country:US
Mailing Address - Phone:707-474-7133
Mailing Address - Fax:
Practice Address - Street 1:3535 65TH ST STE C
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820
Practice Address - Country:US
Practice Address - Phone:916-318-6219
Practice Address - Fax:916-451-1706
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-19
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95006634363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner