Healthcare Provider Details

I. General information

NPI: 1124833835
Provider Name (Legal Business Name): MISS QUINN WRIGHT COLLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BOWMAN DR
VOORHEES NJ
08043-9612
US

IV. Provider business mailing address

500 N 21ST ST APT 603
PHILADELPHIA PA
19130-4248
US

V. Phone/Fax

Practice location:
  • Phone: 856-247-3000
  • Fax:
Mailing address:
  • Phone: 443-759-0072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number26NJ15255100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: