Individual
MRS. JADA C QUINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
4100 N MAIN ST, STE 201, COLUMBIA, SC 29203-5800
(803) 786-1795
(803) 786-6452
Mailing address
4100 N MAIN ST, STE 201, COLUMBIA, SC 29203-5800
(803) 786-1795
(803) 786-6452
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4132
SC
363LA2100X
Acute Care Nurse Practitioner
Primary
4132
SC
363LP2300X
Primary Care Nurse Practitioner
4132
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AA82077370
MEDICARE PTAN
SC
Enumeration date
04/08/2011
Last updated
10/05/2013
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