Amanda Leann Quinn, RN

Individual provider Active NPI General Practice Registered Nurse · Salem, AR

NPI 1285398396 · NPPES record last updated Oct 25, 2021

Key facts

NPI
1285398396
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Registered Nurse 163WG0000X
License
R100508 (AR)
Practice address
193 Stoney Ridge LN
Salem, AR 72576-9071
Phone
(501) 732-0247
NPI assigned
Oct 25, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R100508ARMDGeneral Practice Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X R100508 AR Yes

Addresses

Primary practice location

193 Stoney Ridge LN
Salem, AR 72576-9071

Mailing address

193 Stoney Ridge LN
Salem, AR 72576-9071
Phone (501) 732-0247

Other identifiers

IdentifierTypeStateIssuer
RN100508OtherARRN

Electronic endpoints

TypeEndpointUseAffiliation
Other URL n/a

Other providers in Salem, AR

All providers in Salem, AR · General Practice Registered Nurse in Arkansas

Sources for this page

Verify at the official NPI Registry.