Provider Demographics
NPI:1952403669
Name:QUINN, DEBORA LYNN (NP)
Entity Type:Individual
Prefix:
First Name:DEBORA
Middle Name:LYNN
Last Name:QUINN
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 1:10 E 31ST ST
Mailing Address - Street 2:CHI HEALTH GOOD SAMARITAN
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-2926
Mailing Address - Country:US
Mailing Address - Phone:308-865-7990
Mailing Address - Fax:
Practice Address - Street 1:3219 CENTRAL AVE STE 200
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-2958
Practice Address - Country:US
Practice Address - Phone:308-865-2370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110646363LW0102X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEQ29337Medicare UPIN