Individual provider Active NPI

Lynne M Quallen, RNFA

  • Registered Nurse First Assistant
  • Murray, KY
National Provider Identifier
1912258708
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
1127010 Issued in KY
Practice address
803 Poplar St
Murray, KY 42071-2432
Phone
(270) 752-2200
Fax
(270) 762-1783
NPI assigned
Sep 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X 1127010 KY Primary

Addresses

Primary practice location

803 Poplar St
Murray, KY 42071-2432

Mailing address

300 S 8TH St
Suite 480W
Murray, KY 42071-2400
Phone (270) 762-1781

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

LicenseStateTypeSpecialty
1127010KYMDRegistered Nurse First Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1912258708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S 8TH ST",
            "address_2": "SUITE 480W",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420712400",
            "telephone_number": "270-762-1781",
            "fax_number": "270-762-1783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 POPLAR ST",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420712432",
            "telephone_number": "270-752-2200",
            "fax_number": "270-762-1783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUALLEN",
        "first_name": "LYNNE",
        "middle_name": "M",
        "credential": "RNFA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-20",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "KY",
            "license": "1127010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.