Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1053965145 |
---|---|
Provider Name | Mrs. Katie Lynn Quinn |
First Address | Dayton, OH 45420-3008 |
Second Address | Dayton, OH 45420-3008 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2019 |
Last Update Date | 08/07/2021 |