Individual
MR. TIMOTHY NOBLE HARKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, PA-C, ATC
Contact information
Practice address
1475 RAIDERS WAY, HENDERSON, NV 89052-4604
(725) 780-3406
(725) 780-3540
Mailing address
1235 DIAMOND VALLEY ST, HENDERSON, NV 89052-3019
(510) 305-2991
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2175
NV
363A00000X
Physician Assistant
PA56353
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E1667548
DRIVERS LICENSE
CA
Enumeration date
02/04/2014
Last updated
04/11/2021
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