Individual
MRS. LOIS QUENNEVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
450 E SIGLER AVE, MEMPHIS, MO 63555-1726
(660) 465-8511
(660) 465-2513
Mailing address
450 E SIGLER AVE, MEMPHIS, MO 63555-1726
(660) 465-8511
(660) 465-2513
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2010036798
MO
363A00000X
Physician Assistant
PA00249
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127076103
—
TX
Enumeration date
08/14/2007
Last updated
11/14/2012
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