Provider Demographics
NPI:1447336839
Name:QUILTER, PRISCILLA ELLEN (APRN)
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:ELLEN
Last Name:QUILTER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12 CASE ST
Mailing Address - Street 2:SUITE 313
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2222
Mailing Address - Country:US
Mailing Address - Phone:860-204-9126
Mailing Address - Fax:860-204-9146
Practice Address - Street 1:12 CASE ST
Practice Address - Street 2:SUITE 313
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2222
Practice Address - Country:US
Practice Address - Phone:860-204-9126
Practice Address - Fax:860-204-9146
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2013-09-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT003276363L00000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology