Individual
TIMOTHY MATTHEW RACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, CRNP, PMHNP-BC
Contact information
Practice address
142 DAVENPORT ST, PLYMOUTH, PA 18651-1604
(570) 899-1871
Mailing address
142 DAVENPORT ST, PLYMOUTH, PA 18651-1604
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP028392
PA
Other
Enumeration date
10/26/2023
Last updated
12/04/2023
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