Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | MW010480 | PA |
NPI | 1003324153 |
---|---|
Provider Name | Ms. Nicole Marie Quintero |
First Address | Harrisburg, PA 17110-2033 |
Second Address | Harrisburg, PA 17110-2001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2018 |
Last Update Date | 14/04/2021 |