Active NPI
Quincy Eastlack
- Critical Care Medicine Registered Nurse
- Tucson, AZ
National Provider Identifier
1205715489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine Registered Nurse
- License
- 239014
- Practice address
- 5301 E Grant Rd
Tucson, AZ 85712-2805 - Phone
- (520) 327-5461
- NPI assigned
- Sep 1, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 239014 | AZ | Primary |
Addresses
Primary practice location
5301 E Grant Rd
Tucson, AZ 85712-2805
Mailing address
166 E Bowers CT
Tucson, AZ 85704-6548
Phone (913) 957-0420
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 239014 | AZ | MD | Critical Care Medicine Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1756684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756684800000",
"number": "1205715489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "166 E BOWERS CT",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857046548",
"telephone_number": "913-957-0420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5301 E GRANT RD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857122805",
"telephone_number": "520-327-5461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EASTLACK",
"first_name": "QUINCY",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2025-09-01",
"last_updated": "2025-09-01",
"certification_date": "2025-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "AZ",
"license": "239014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.