Individual
MRS. CONNIE KIM QUINTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN MSN FNP
Contact information
Practice address
590 E 100 N STE 6, PRICE, UT 84501-2600
(435) 613-9466
(435) 613-9469
Mailing address
590 E 100 N STE 6, PO BOX 1734, PRICE, UT 84501-2600
(435) 613-9466
(435) 613-9469
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0190288-8900
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01902884401001
BCBS
UT
01
—
0251516
PEHP
UT
01
—
46D1010536
CLIA
UT
01
—
603509700
WORKERS COMP
UT
01
—
7076446
AETNA
UT
01
—
87-0530876
TAX ID
UT
01
—
870530876
TRICARE
UT
01
—
QM0000064041
ALTIUS
UT
Enumeration date
08/30/2005
Last updated
01/29/2013
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