1851354294 NPI number — MRS. APRIL MARIE QUIGLEY PA-C

Table of content: MRS. APRIL MARIE QUIGLEY PA-C (NPI 1851354294)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851354294 NPI number — MRS. APRIL MARIE QUIGLEY PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
QUIGLEY
Provider First Name:
APRIL
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FREUNDL
Provider Other First Name:
APRIL
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
PA-C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1851354294
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/22/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1431 PREMIER DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANKATO
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56001-6076
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-386-6600
Provider Business Mailing Address Fax Number:
507-625-5971

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1431 PREMIER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANKATO
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56001-6076
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-386-6600
Provider Business Practice Location Address Fax Number:
507-625-5971
Provider Enumeration Date:
04/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  9902 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 410940705H034 . This is a "TRICARE/WPS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 380462300 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 983181041608 . This is a "PREFERRED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: HP44069 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 489T6FR . This is a "BCBS OF MN" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 0119127 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 132151C572 . This is a "UCARE MN" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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