Healthcare Provider Details

I. General information

NPI: 1275767808
Provider Name (Legal Business Name): QUINN MARQUIS BOWERS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2009
Last Update Date: 09/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 SUDBROOK LN # 3
PIKESVILLE MD
21208-4117
US

IV. Provider business mailing address

4 SUDBROOK LN # 3
PIKESVILLE MD
21208-4117
US

V. Phone/Fax

Practice location:
  • Phone: 443-253-2940
  • Fax: 443-817-0893
Mailing address:
  • Phone: 443-253-2940
  • Fax: 443-817-0893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR184525
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: