Individual
TIMOTHY JOSEPH PALMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
80 NEWNAN STATION DR, SUITE A, NEWNAN, GA 30265-3194
(770) 251-2060
Mailing address
PO BOX 73709, NEWNAN, GA 30271-3709
(770) 251-2060
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
4704174508
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
RN242299
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3034639
—
MI
01
—
430F364420
BCBSM
MI
Enumeration date
03/02/2006
Last updated
02/04/2015
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