Individual
MAKENSIE RAE QUINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-1000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(822) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2322
NE
363A00000X
Physician Assistant
Primary
5118
WI
363A00000X
Physician Assistant
8462
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100205923
—
WI
Enumeration date
02/13/2019
Last updated
09/10/2024
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