Provider Demographics
NPI:1912909607
Name:QUINN, KATHLEEN CABONI (EDD, WHNP)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:CABONI
Last Name:QUINN
Suffix:
Gender:F
Credentials:EDD, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 268
Mailing Address - Street 2:
Mailing Address - City:PASS CHRISTIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39571-0268
Mailing Address - Country:US
Mailing Address - Phone:601-467-0041
Mailing Address - Fax:
Practice Address - Street 1:744 E SECOND ST
Practice Address - Street 2:
Practice Address - City:PASS CHRISTIAN
Practice Address - State:MS
Practice Address - Zip Code:39571-4628
Practice Address - Country:US
Practice Address - Phone:601-467-0041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0291101YP2500X
TX16462101YP2500X
LA03-06-88101YP2500X
TX668367363LW0102X
MSR87655363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health