Provider Demographics
NPI:1871302943
Name:QUINTANILLA, ELLA SOPHIA
Entity type:Individual
Prefix:MRS
First Name:ELLA
Middle Name:SOPHIA
Last Name:QUINTANILLA
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 1:1015 N 45TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68503-2223
Mailing Address - Country:US
Mailing Address - Phone:402-202-5168
Mailing Address - Fax:
Practice Address - Street 1:1015 N 45TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68503-2223
Practice Address - Country:US
Practice Address - Phone:402-202-5168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider