Provider Demographics
NPI:1538801576
Name:QUINLIN, ABIGAIL TATE
Entity type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:TATE
Last Name:QUINLIN
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 1:1060 TWIN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:DOE RUN
Mailing Address - State:MO
Mailing Address - Zip Code:63637-3190
Mailing Address - Country:US
Mailing Address - Phone:636-375-9283
Mailing Address - Fax:
Practice Address - Street 1:600 W KARSCH BLVD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-3342
Practice Address - Country:US
Practice Address - Phone:573-747-1591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022010907183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2022010907OtherMISSOURI BOARD OF PHARMACY LICENSE NUMBER