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Individual

MRS. ANGELICA LAUREN TIMMERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
1856 THOMPSON BRIDGE RD STE 14, GAINESVILLE, GA 30501-1620
(770) 219-9460
(770) 219-9461
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(772) 219-8420

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
22593
SC
363LF0000X
Family Nurse Practitioner
Primary
RN215693
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003169456C
GA
05
003169456D
GA
01
04721916
AMERIGROUP
GA
Enumeration date
08/04/2015
Last updated
08/10/2023
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