Individual
AMANDA SUZANN TIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4010 DUPONT CIR STE L28, LOUISVILLE, KY 40207-4825
(502) 749-6565
Mailing address
5303 GLYNDON WAY, LOUISVILLE, KY 40272-4367
(502) 881-7198
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4016812
KY
363LF0000X
Family Nurse Practitioner
Primary
4016812
KY
Other
Enumeration date
07/09/2024
Last updated
07/16/2024
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