MEDICARE: LORI QUINN-TATE R.N., M.N.

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	364S00000X	Clinical Nurse Specialist	57864	LA
2	364S00000X	Clinical Nurse Specialist	AP01117	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588666762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI QUINN-TATE R.N., M.N.

Provider Business Mailing Address
First Line	:	5959 S SHERWOOD FOREST BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-6038
Country	:	US
Telephone Number	:	225-767-3900
Fax Number	:	225-765-9196

Provider Business Practice Location Address
First Line	:	7777 HENNESSY BLVD STE 1000
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-4370
Country	:	US
Telephone Number	:	225-767-3900
Fax Number	:	225-766-2226

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	05/12/2022

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