Individual
KATHLEEN TIMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
550 1ST AVE, NEW YORK, NY 10016-6402
(609) 240-9636
Mailing address
42 HINKLE DR, BORDENTOWN, NJ 08505-2722
(609) 240-9636
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
769992-1
NY
363LA2100X
Acute Care Nurse Practitioner
Primary
769992-1
NY
Other
Enumeration date
10/11/2019
Last updated
12/18/2019
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