MEDICARE: BRIANNE QUINTIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	26NR19803700	NJ
2	163W00000X	Registered Nurse	784677-01	NY
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	26NJ15033800	NJ
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	405604	NY

General Provider Information

NPI Number	:	1093586166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNE QUINTIN

Provider Business Mailing Address
First Line	:	100 INTERNATIONAL DR FL 23
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21202-4737
Country	:	US
Telephone Number	:	888-684-2779
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 INTERNATIONAL DR FL 23
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21202-4737
Country	:	US
Telephone Number	:	888-684-2779
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2024
Last Update Date	:	05/22/2024

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Directions to “ BRIANNE QUINTIN ” Practice Location

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