Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 05-42210 | KS |
N | 2080P0203X | Pediatric Critical Care Doctor | 76818 | GA |
NPI | 1114260676 |
---|---|
Provider Name | Monica Quinn |
First Address | Wichita, KS 67214-4910 |
Second Address | Kansas City, MO 64108-4619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2013 |
Last Update Date | 04/01/2022 |