Individual
JULIE LYNN TIMMERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1000 LIPSCOMB ST STE 110, FORT WORTH, TX 76104-3181
(817) 348-8600
Mailing address
PO BOX 650865, DALLAS, TX 75265-0865
(972) 715-5000
(972) 715-9976
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
720416
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180430403
—
TX
01
—
8874UG
BCBS
TX
01
—
P01338248
RR
TX
Enumeration date
07/26/2006
Last updated
09/10/2020
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