Individual
LUIS QUINTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
6309 E BAYWOOD AVE, MESA, AZ 85206-1744
(480) 325-3801
(480) 325-3805
Mailing address
PO BOX 13550, MESA, AZ 85216-3550
(480) 325-3801
(480) 325-3805
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN109891 AP1969
AZ
364SN0800X
Neuroscience Clinical Nurse Specialist
RN109891 AP1969
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
958407
—
AZ
Enumeration date
06/30/2005
Last updated
01/29/2008
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