Marjory W Quammie, ARNP

Individual provider Active NPI Women's Health Nurse Practitioner · Daytona Beach, FL

NPI 1063473262 · NPPES record last updated Dec 13, 2012

Key facts

NPI
1063473262
Entity type
Individual (NPI type 1)
Primary specialty
Women's Health Nurse Practitioner 363LW0102X
License
ARNP 1492332 (FL)
Practice address
1845 Holsonback Dr
Daytona Beach, FL 32117-5114
Phone
(386) 274-0790
Fax
(386) 274-0800
NPI assigned
Mar 29, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
ARNP 1492332FLMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Dept. of Health Past Accepting new patients
Florida Department of Health Past
since Oct 9, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X ARNP 1492332 FL Yes

Addresses

Primary practice location

1845 Holsonback Dr
Daytona Beach, FL 32117-5114

Mailing address

PO Box 9190
Daytona Beach, FL 32120-9190
Phone (386) 274-0790

Other identifiers

IdentifierTypeStateIssuer
301357001MedicaidFL

Other providers in Daytona Beach, FL

All providers in Daytona Beach, FL · Women's Health Nurse Practitioner in Florida

Sources for this page

Verify at the official NPI Registry.