Healthcare Provider Details

I. General information

NPI: 1144429325
Provider Name (Legal Business Name): ROBIN GAY QUIRE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 PREVATT RD
DOTHAN AL
36301-5427
US

IV. Provider business mailing address

1133 CO. RD. 445
ENTERPRISE AL
36330
US

V. Phone/Fax

Practice location:
  • Phone: 334-794-0731
  • Fax:
Mailing address:
  • Phone: 334-347-7688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-070213
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: