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NPI Code Detail

MEDICARE: COLLIN QUINLAN

MEDICARE:   COLLIN  QUINLAN
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
1363A00000XPhysician Assistant10005057AIN

General Provider Information

NPI Number : 1659262483
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLLIN QUINLAN
Provider Business Mailing Address
First Line : 11109 PARKVIEW PLAZA DR # 117
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8 JOHN KISSINGER DR
Second Line :
City : WABASH
State : IN
Zip : 46992-1648
Country : US
Telephone Number : 260-563-7451
Fax Number : 260-569-2284
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2025
Last Update Date : 12/02/2025

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Directions to “ COLLIN QUINLAN ” Practice Location

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