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General NPI Number Information
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NPI Number | 1114744927
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Entity Type | Individual
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Provider Name | CRISTINA QUIROZ AGPCNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/23/2024
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 3100 45TH ST STE 4
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City | HIGHLAND
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State | IN
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Zip | 46322-3277
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Country | US
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Telephone | 219-922-6911
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Fax | 219-922-6968
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Provider Business Mailing Address
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Address Line | 608 W 145TH ST
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City | EAST CHICAGO
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State | IN
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Zip | 46312-3234
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Country | US
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Telephone |
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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 | 71015941A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28278391A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28278391C
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License Number State | IN
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