Healthcare Provider Details

I. General information

NPI: 1649120189
Provider Name (Legal Business Name): ALEXANDRIA LYNNE QUINN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALEX LYNNE QUINN

II. Dates (important events)

Enumeration Date: 02/03/2026
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4511 ALBATROSS ST
NORTH MYRTLE BEACH SC
29582-6503
US

IV. Provider business mailing address

4511 ALBATROSS ST
NORTH MYRTLE BEACH SC
29582-6503
US

V. Phone/Fax

Practice location:
  • Phone: 843-360-1638
  • Fax:
Mailing address:
  • Phone: 843-360-1638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberLMW-0133
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: