Provider Demographics
NPI:1932157096
Name:MCFETRIDGE, HALLIE QUINN (AP)
Entity Type:Individual
Prefix:MS
First Name:HALLIE
Middle Name:QUINN
Last Name:MCFETRIDGE
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 NW 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-2837
Mailing Address - Country:US
Mailing Address - Phone:352-373-1020
Mailing Address - Fax:
Practice Address - Street 1:2510 NW 23RD AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-2837
Practice Address - Country:US
Practice Address - Phone:352-373-1020
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL982171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist