Individual
MRS. JESSIE MARIE QUINTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANPBC
Contact information
Practice address
151 CENTRAL MAIN ST, PUEBLO, CO 81003-4212
(719) 583-4380
(719) 583-4375
Mailing address
334 N BENITO DR, PUEBLO WEST, CO 81007-1180
(719) 564-2350
(719) 583-4375
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
51741
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40551741
—
CO
01
—
51741
RN LICENSE NUMBER
CO
Enumeration date
01/26/2007
Last updated
03/07/2023
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