Individual
REVADEAN J QUASTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, NP-C, APNP
Contact information
Practice address
717 S STATE ST STE 900, FAIRMONT, MN 56031
(072) 384-9495
Mailing address
717 S STATE ST STE 900, FAIRMONT, MN 56031-4478
(072) 384-9495
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
4555-33
WI
363LF0000X
Family Nurse Practitioner
Primary
6831
MN
Other
Enumeration date
12/02/2011
Last updated
09/11/2019
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