Provider Demographics
NPI:1396073581
Name:QUINONES, KIMBERLY D (R EEG T)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:D
Last Name:QUINONES
Suffix:
Gender:F
Credentials:R EEG T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 GOVERNMENT BLVD
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-2795
Mailing Address - Country:US
Mailing Address - Phone:256-226-9972
Mailing Address - Fax:
Practice Address - Street 1:106 GOVERNMENT BLVD
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-2795
Practice Address - Country:US
Practice Address - Phone:256-226-9972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4343246ZE0500X, 246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
No246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG