Active NPI
Jessie Marie Quintana, ANPBC
- Nurse Practitioner
- Pueblo, CO
National Provider Identifier
1619023199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 51741
- Practice address
- 151 Central Main St
Pueblo, CO 81003-4212 - Phone
- (719) 583-4380
- Fax
- (719) 583-4375
- NPI assigned
- Jan 26, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 51741 | CO | Primary |
Addresses
Primary practice location
151 Central Main St
Pueblo, CO 81003-4212
Mailing address
334 N Benito Dr
Pueblo West, CO 81007-1180
Phone (719) 564-2350
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40551741 | Medicaid | CO | |
| 51741 | Other | CO | RN LICENSE NUMBER |
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 |
|---|---|---|---|
| 51741 | CO | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1619023199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "334 N BENITO DR",
"city": "PUEBLO WEST",
"state": "CO",
"postal_code": "810071180",
"telephone_number": "719-564-2350",
"fax_number": "719-583-4375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 CENTRAL MAIN ST",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810034212",
"telephone_number": "719-583-4380",
"fax_number": "719-583-4375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUINTANA",
"first_name": "JESSIE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "ANPBC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-26",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CO",
"license": "51741",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40551741",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSE NUMBER",
"identifier": "51741",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.