Individual
BRIAN D TIMMERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
18704 E 610 RD, INOLA, OK 74036-5566
(918) 633-7166
Mailing address
18704 E 610 RD, INOLA, OK 74036-5566
(918) 633-7166
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R64604
OK
Other
Enumeration date
04/05/2013
Last updated
04/05/2013
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