Provider Demographics
NPI:1306940820
Name:QUINKERT, ELIZABETH A (CNM)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:QUINKERT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:BARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:301 W 13TH ST
Mailing Address - Street 2:201
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3764
Mailing Address - Country:US
Mailing Address - Phone:812-282-6114
Mailing Address - Fax:812-282-6340
Practice Address - Street 1:301 GORDON GUTMANN BLVD STE 201
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3766
Practice Address - Country:US
Practice Address - Phone:812-282-6114
Practice Address - Fax:812-280-2142
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28106154A363L00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200201490AMedicaid