MEDICARE: AMBER QUINN

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	363LF0000X	Family Nurse Practitioner	4704330125NSA230TF	MI

General Provider Information

NPI Number	:	1881474534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER QUINN

Provider Business Mailing Address
First Line	:	25 COLUMBIA AVE E
Second Line	:
City	:	BATTLE CREEK
State	:	MI
Zip	:	49015-3703
Country	:	US
Telephone Number	:	269-425-3017
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 COLUMBIA AVE E
Second Line	:
City	:	BATTLE CREEK
State	:	MI
Zip	:	49015-3703
Country	:	US
Telephone Number	:	269-425-3017
Fax Number	:

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

Provider Enumeration Date	:	10/02/2023
Last Update Date	:	04/25/2024

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