Healthcare Provider Details

I. General information

NPI: 1831242270
Provider Name (Legal Business Name): JENNIFER QUINN N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 10/01/2020
Certification Date: 10/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 GREENLAND RD UNIT B11
PORTSMOUTH NH
03801-4162
US

IV. Provider business mailing address

91 FALL MILL RD
YORK ME
03909-5733
US

V. Phone/Fax

Practice location:
  • Phone: 603-945-8119
  • Fax: 833-645-0925
Mailing address:
  • Phone: 207-752-4477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNH29
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: