Healthcare Provider Details

I. General information

NPI: 1780320168
Provider Name (Legal Business Name): DEBRA ANN QUINTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2022
Last Update Date: 05/09/2022
Certification Date: 05/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 THURBERS AVE
PROVIDENCE RI
02905-4754
US

IV. Provider business mailing address

311 GREENWOOD AVE
WARWICK RI
02886-2027
US

V. Phone/Fax

Practice location:
  • Phone: 401-331-1350
  • Fax:
Mailing address:
  • Phone: 401-222-0713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN46642
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN46642
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberRN46642
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: