Healthcare Provider Details

I. General information

NPI: 1548851785
Provider Name (Legal Business Name): TIMOTHY STEPHEN MCAFEE APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2021
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 W INDIAN TRL
MILAN IN
47031-8992
US

IV. Provider business mailing address

PO BOX 635283
CINCINNATI OH
45263-5283
US

V. Phone/Fax

Practice location:
  • Phone: 812-496-8784
  • Fax: 812-654-7158
Mailing address:
  • Phone: 812-496-8784
  • Fax: 812-654-7158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71010783A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71010783A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: