Healthcare Provider Details

I. General information

NPI: 1962644559
Provider Name (Legal Business Name): M. PATRICIA QUINLISK MD. MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2009
Last Update Date: 03/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 E 12TH ST LUCAS STATE OFFICE BUILDING
DES MOINES IA
50319-1002
US

IV. Provider business mailing address

321 E 12TH ST LUCAS STATE OFFICE BUILDING
DES MOINES IA
50319-1002
US

V. Phone/Fax

Practice location:
  • Phone: 515-281-4941
  • Fax: 515-281-4958
Mailing address:
  • Phone: 515-281-4941
  • Fax: 515-281-4958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number30730
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: