Look up the most recent NPI and PECOS records

Matias Miguel Quintanilla

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

1449 N 1400 W Ste 19, St George, UT 84770-5237

PECOS Enrollment

Based on the most recent information from CMS, provider Matias Miguel Quintanilla does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1306534458
Provider Type
Individual
Full Name
Quintanilla, Matias Miguel
Credential
MSN APRN FNP-BC

Gender
Male
Sole Proprietor
No
Enumeration Date
4/26/2023
Last Updated
5/31/2024

Contact Information

Practice Location

1449 N 1400 W Ste 19, St George, UT 84770-5237

(435) 688-7572

(435) 688-8191

Mailing Location

415 W Tabernacle St Ste 2, St George, UT 84770-3797

(435) 656-1777

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 11475617-4405 Utah
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License 11475617-4408 Utah
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License 11475617-3102 Utah

Matias Miguel Quintanilla

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Borrowman, Ryan T

Tracy, Annalie

Langston Kirkland, Jilleen

Bedke, Coalette

Mccook, Nathaniel Thomas

Christensen, William Bentley

Miner, Jennica Marlee

Christensen, Jordan Michelle

Watts, Jennette

Bingham, Codie