Provider Demographics
NPI:1912619941
Name:MCQUINN, GEORGIA SUE (RN)
Entity Type:Individual
Prefix:MRS
First Name:GEORGIA
Middle Name:SUE
Last Name:MCQUINN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 BLAIR PIKE
Mailing Address - Street 2:
Mailing Address - City:PERU
Mailing Address - State:IN
Mailing Address - Zip Code:46970-1507
Mailing Address - Country:US
Mailing Address - Phone:765-473-4426
Mailing Address - Fax:765-472-7609
Practice Address - Street 1:317 BLAIR PIKE
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:IN
Practice Address - Zip Code:46970-1507
Practice Address - Country:US
Practice Address - Phone:765-473-4426
Practice Address - Fax:765-472-7609
Is Sole Proprietor?:No
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28183195A163W00000X
IN28233985A163WC0400X
IN28133270A163WI0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0600XNursing Service ProvidersRegistered NurseInfection Control
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management