Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Quinta Fonkwa

Individual provider Clinic/Center · NPI 1417722695

Quinta Fonkwa is a Nurse Practitioner in Dallas, Texas. Qualified in 2022, 4 years ago. Practices with Lightflower, Ltd, a 7-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Texas.

Years since qualifying
4
Licensed in
TX
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

5315 Ross Ave
Dallas, TX 75206-7418
Phone: (214) 826-2151
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 1140421 (TX)
Clinic/Center Taxonomy 261Q00000X (TX)

Record details

NPI number1417722695
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedNovember 17, 2023
Last updated in NPPESNovember 25, 2025
Certification dateNovember 25, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Lightflower, Ltd. — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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