Individual
KYLIE MARIE TIMMERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1350 E MAIN ST, GRASS VALLEY, CA 95945-5208
(530) 477-9532
Mailing address
463 BUCKEYE ST, VACAVILLE, CA 95688-2630
(707) 365-4694
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
95133062
CA
Other
Enumeration date
11/09/2020
Last updated
11/09/2020
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