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Individual

MARIE R. TIMOTHY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1750 E 3100 N, LAYTON, UT 84040-2406
(801) 773-4840
(801) 525-3164
Mailing address
2121 N 1700 W, LAYTON, UT 84041-8803
(801) 773-4840
(801) 525-3164

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
327899-4405
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
327899-4405
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000055266
MEDICARE PIN
UT
01
260022408
RAILROAD MEDICARE
UT
05
8760003008007
UT
05
U000113063
UT
Enumeration date
09/04/2019
Last updated
12/19/2024
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