Individual
MRS. TONYA H. QUINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1171 HART ST, CANTON, MS 39046-4805
(601) 859-9888
Mailing address
1171 HART ST, CANTON, MS 39046-4805
(601) 859-9888
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R866176
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09689816
—
MS
01
—
409789ZGP
MEDICARE
MS
Enumeration date
04/09/2015
Last updated
08/23/2016
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