Individual
MR. CHRISTOPHER LOUIS TIMMINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
12450 LA GRANGE RD, LOUISVILLE, KY 40245-1901
(502) 638-4783
Mailing address
PO BOX 932958, CLEVELAND, OH 44193-4431
(888) 852-2567
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3012446
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111832
MEDICARE PTAN
—
05
—
403251185E
—
GA
01
—
GRP 1855
MEDICARE GROUP PTAN
—
01
—
RN202115NP
LICENSE
GA
Enumeration date
09/14/2006
Last updated
02/06/2025
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