Healthcare Provider Details

I. General information

NPI: 1629220439
Provider Name (Legal Business Name): LINDA MARIE QUINLIN NP AND CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2008
Last Update Date: 10/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 WILMINGTON AVE
DAYTON OH
45420-1890
US

IV. Provider business mailing address

324 WILMINGTON AVE
DAYTON OH
45420-1890
US

V. Phone/Fax

Practice location:
  • Phone: 937-256-4490
  • Fax: 937-256-9802
Mailing address:
  • Phone: 937-256-4490
  • Fax: 937-256-9802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP-10292
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberNS-08303
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: