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General NPI Number Information
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NPI Number | 1376098947
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Entity Type | Individual
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Provider Name | TESA QUINN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/23/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 24944 HIGHWAY 15
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City | UNION
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State | MS
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Zip | 39365-8587
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Country | US
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Telephone | 601-616-4212
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Fax |
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Provider Business Mailing Address
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Address Line | 107 WOODHAVEN DR
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City | UNION
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State | MS
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Zip | 39365-2703
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Country | US
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Telephone | 601-616-4212
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | E-09949
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License Number State | MS
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