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Individual

TIMOTHY P.A. PRIETO-KOP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
315 LIBERTY STREET, WAYNESBORO, GA 30830
(706) 554-4435
Mailing address
225 SHADY OAK LANE, WAYNESBORO, GA 30830
(706) 554-5171

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
23367.0820
WY
367500000X
Certified Registered Nurse Anesthetist
APN.0005022-CRNA
CO
367500000X
Certified Registered Nurse Anesthetist
Primary
RN185024
GA

Other

Enumeration date
09/06/2006
Last updated
05/06/2020
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