MEDICARE: ANDY QUIJADA ATC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer		NE

General Provider Information

NPI Number	:	1053246900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDY QUIJADA ATC

Provider Business Mailing Address
First Line	:	706 E LINDEN ST
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72756-6019
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	710 N TURNER AVE
Second Line	:
City	:	HASTINGS
State	:	NE
Zip	:	68901-7621
Country	:	US
Telephone Number	:	800-532-7642
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

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Directions to “ ANDY QUIJADA ATC” Practice Location

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