Provider Demographics
NPI:1871330613
Name:ELIAS, QUINN TOOKEY (CRNA)
Entity type:Individual
Prefix:
First Name:QUINN
Middle Name:TOOKEY
Last Name:ELIAS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JOSIE
Other - Middle Name:QUINN
Other - Last Name:TOOKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1425 COVINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-4642
Mailing Address - Country:US
Mailing Address - Phone:817-404-7160
Mailing Address - Fax:
Practice Address - Street 1:900 S CATON AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5201
Practice Address - Country:US
Practice Address - Phone:667-234-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR252930367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered