Healthcare Provider Details

I. General information

NPI: 1639421167
Provider Name (Legal Business Name): WHITNEY ELIZABETH QUAST M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: WHITNEY ELIZABETH HAY

II. Dates (important events)

Enumeration Date: 10/08/2012
Last Update Date: 10/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 FAIRVIEW BLVD
RED WING MN
55066-2848
US

IV. Provider business mailing address

23521 BELMONT ST
HAMPTON MN
55031-9647
US

V. Phone/Fax

Practice location:
  • Phone: 651-267-5460
  • Fax: 651-267-5946
Mailing address:
  • Phone: 715-222-2960
  • Fax: 651-267-5946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Y00000X
TaxonomyClinical Exercise Physiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: