Individual
MATIAS MIGUEL QUINTANILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN APRN FNP-BC
Contact information
Practice address
786 W PIONEER BLVD STE A, MESQUITE, NV 89027-8862
(702) 345-5000
(702) 345-2000
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3346
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11475617-3102
UT
207Q00000X
Family Medicine Physician
11475617-4408
UT
363LF0000X
Family Nurse Practitioner
11475617-4405
UT
363LF0000X
Family Nurse Practitioner
Primary
841346
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306534458
—
NV
01
—
841346
STATE LICENSE
NV
Enumeration date
04/26/2023
Last updated
11/02/2025
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