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General NPI Number Information
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NPI Number | 1972605202
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Entity Type | Individual
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Provider Name | CRYSTAL SATONA QUINCE MBA,PNHNP-BC,FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 09/15/2023
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Provider Practice Location Address
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Address Line | 5000 W MIDWAY ROAD UNIT 13317
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City | FORT PIERCE
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State | FL
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Zip | 34981-1900
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Country | US
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Telephone | 877-825-7846
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Fax | 877-881-1049
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Provider Business Mailing Address
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Address Line | 5000 W MIDWAY RD # 13317
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City | FORT PIERCE
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State | FL
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Zip | 34981-4827
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Country | US
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Telephone | 833-379-1898
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Fax | 877-881-1049
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2021013806
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | APRN9290324
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2018004992
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License Number State | FL
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