Provider Demographics
NPI:1417653023
Name:QUINTANILLA, BRIDGET SALINA (FNP-S)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:SALINA
Last Name:QUINTANILLA
Suffix:
Gender:F
Credentials:FNP-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1492 S SILICON WAY
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-7155
Mailing Address - Country:US
Mailing Address - Phone:435-656-8918
Mailing Address - Fax:
Practice Address - Street 1:1492 S SILICON WAY
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-7155
Practice Address - Country:US
Practice Address - Phone:435-656-8918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5252020-4405363LP2300X, 207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care