Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 0024168798 | VA |
NPI | 1003123837 |
---|---|
Provider Name | Cecille M Quinn |
First Address | Norfolk, VA 23502-3978 |
Second Address | Virginia Beach, VA 23454-3074 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2010 |
Last Update Date | 12/11/2016 |