Provider Demographics
NPI:1730725730
Name:QUESNELL, GINA M
Entity type:Individual
Prefix:MRS
First Name:GINA
Middle Name:M
Last Name:QUESNELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 345
Mailing Address - Street 2:
Mailing Address - City:CASSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13318-0345
Mailing Address - Country:US
Mailing Address - Phone:315-292-8681
Mailing Address - Fax:
Practice Address - Street 1:1678 MAIN STREET
Practice Address - Street 2:
Practice Address - City:CASSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13318
Practice Address - Country:US
Practice Address - Phone:315-292-8681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-25
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant