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General NPI Number Information
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NPI Number | 1053204685
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Entity Type | Individual
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Provider Name | KAITLYN QUINN
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Gender | Female
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 3111 W RAWSON AVE
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City | FRANKLIN
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State | WI
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Zip | 53132-9417
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Country | US
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Telephone | 414-260-5544
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Fax |
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Provider Business Mailing Address
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Address Line | 8034 W WATERFORD AVE
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City | MILWAUKEE
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State | WI
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Zip | 53220-2243
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Country | US
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Telephone | 414-531-8430
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 15895-33
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License Number State | WI
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