Provider Demographics
NPI:1437328846
Name:QUINN, WENDY LYNN (RNC,MSN)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:LYNN
Last Name:QUINN
Suffix:
Gender:F
Credentials:RNC,MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20055 LOFTYPINE LN
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-8040
Mailing Address - Country:US
Mailing Address - Phone:719-488-3431
Mailing Address - Fax:
Practice Address - Street 1:20055 LOFTYPINE LN
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-8040
Practice Address - Country:US
Practice Address - Phone:719-488-3431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO79225363LN0005X, 363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care