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Individual

BROOKE A QUILTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
903 W MARTIN ST, SAN ANTONIO, TX 78207
(210) 358-5467
Mailing address
903 W MARTIN ST, SAN ANTONIO, TX 78207-0903
(210) 358-5467

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP129334
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
AP129334
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
368787301
TX
05
368787303
TX
01
562968YLLW
MEDICARE TPAN
TX
01
8527MB
BCBS
TX
Enumeration date
10/13/2015
Last updated
11/14/2019
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