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Individual
QUINCY VINCENT LODGE
Active
Individual
QUINCY VINCENT LODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
26NR12004300
NJ
163WC0200X
Critical Care Medicine Registered Nurse
558308-1
NY
163WC0200X
Critical Care Medicine Registered Nurse
RN583285
PA
367500000X
Certified Registered Nurse Anesthetist
583285
PA
367500000X
Certified Registered Nurse Anesthetist
854745
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP125701
TX
Other
Enumeration date
12/27/2007
Last updated
04/16/2024
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