Healthcare Provider Details

I. General information

NPI: 1841497294
Provider Name (Legal Business Name): BARBARA THIMGAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 W 3RD ST ROOM 111
LA JUNTA CO
81050-1536
US

IV. Provider business mailing address

13 W 3RD ST
LA JUNTA CO
81050-1536
US

V. Phone/Fax

Practice location:
  • Phone: 719-383-3040
  • Fax: 719-383-3060
Mailing address:
  • Phone: 719-383-3040
  • Fax: 719-383-3060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number45261
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: