Provider Demographics
NPI:1427146315
Name:QUINN, CATHERINE MARY (CRNP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MARY
Last Name:QUINN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:CATE
Other - Middle Name:MARY
Other - Last Name:HOLDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5272 SUMMERLIN COMMONS WAY STE 603
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-2156
Mailing Address - Country:US
Mailing Address - Phone:239-444-8969
Mailing Address - Fax:239-466-2035
Practice Address - Street 1:5272 SUMMERLIN COMMONS WAY STE 603
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-2156
Practice Address - Country:US
Practice Address - Phone:239-444-8969
Practice Address - Fax:239-466-2035
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR101987363L00000X
FLARNP9299468363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP00284024OtherRR MEDICARE
S25049Medicare UPIN
MD665MN029Medicare ID - Type Unspecified
MDP00284024OtherRR MEDICARE