Healthcare Provider Details

I. General information

NPI: 1326031089
Provider Name (Legal Business Name): QUINALIN CARIN EASLEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2005
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FORT JACKSON -MONCRIEF 4500 8TH DIVISION STREET
FORT JACKSON SC
29207
US

IV. Provider business mailing address

4500 8TH DIVISION RD
COLUMBIA SC
29207-5700
US

V. Phone/Fax

Practice location:
  • Phone: 803-751-7754
  • Fax:
Mailing address:
  • Phone: 803-751-7754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1064184
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: