Individual
AMANDA LEANN QUINN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
193 STONEY RIDGE LN, SALEM, AR 72576-9071
(501) 732-0247
Mailing address
193 STONEY RIDGE LN, SALEM, AR 72576-9071
(501) 732-0247
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
R100508
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN100508
RN
AR
Enumeration date
10/25/2021
Last updated
10/25/2021
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