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Individual
MOLLY QUINN
Active
Individual
MOLLY QUINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
28303
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619302742
—
MT
01
—
M011004058
MEDICARE
MT
Enumeration date
09/09/2013
Last updated
11/23/2021
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