Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | AP9003 | AZ |
N | 363LF0000X | Nurse Practitioner - Family Medicine | AP9003 | AZ |
NPI | 1003269697 |
---|---|
Provider Name | Perla Quinones |
First Address | San Tan Valley, AZ 85140-7334 |
Second Address | San Tan Valley, AZ 85140-7334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2016 |
Last Update Date | 09/07/2019 |