Basic Information
| Provider Information | |||||||||
| NPI: | 1245484641 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | QUINN | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 575 BEECH ST | ||||||||
| Address2: | |||||||||
| City: | HOLYOKE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010402223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135342500 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 575 BEECH ST | ||||||||
| Address2: | |||||||||
| City: | HOLYOKE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010402223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135342500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/12/2008 | ||||||||
| LastUpdateDate: | 12/23/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | RN277449 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 163W00000X | 277449 | MA | N | Nursing Service Providers | Registered Nurse | 363L00000X | RN277449 | MA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.