Healthcare Provider Details

I. General information

NPI: 1720348212
Provider Name (Legal Business Name): SUSAN NIRMAL QUINN REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2012
Last Update Date: 05/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5231 PENN AVE
PITTSBURGH PA
15224-1768
US

IV. Provider business mailing address

6309 ALDERSON ST
PITTSBURGH PA
15217-2501
US

V. Phone/Fax

Practice location:
  • Phone: 412-580-8730
  • Fax:
Mailing address:
  • Phone: 412-580-8730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN183281L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: