Provider Demographics
NPI:1053965145
Name:QUINN, KATIE LYNN (CPM)
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:LYNN
Last Name:QUINN
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 HAZEL AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45420-3008
Mailing Address - Country:US
Mailing Address - Phone:937-216-1130
Mailing Address - Fax:
Practice Address - Street 1:2825 HAZEL AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45420-3008
Practice Address - Country:US
Practice Address - Phone:937-216-1130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-28
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty