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General NPI Number Information
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NPI Number | 1285717371
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Entity Type | Individual
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Provider Name | JOYCE MACHIN QUINTAVALLE CRNP-P
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Gender | Female
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 501 STEMMERS RUN RD
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City | BALTIMORE
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State | MD
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Zip | 21221-3333
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Country | US
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Telephone | 410-574-4397
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Fax | 410-574-4397
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Provider Business Mailing Address
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Address Line | 17326 BUSHLAND RD
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City | PARKTON
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State | MD
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Zip | 21120-9476
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Country | US
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Telephone | 410-343-1503
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Fax | 410-343-1562
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | RO41468
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License Number State | MD
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