Healthcare Provider Details

I. General information

NPI: 1346586518
Provider Name (Legal Business Name): JAMIE ANN TIMBERMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2012
Last Update Date: 12/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8800 MONTGOMERY BLVD NE
ALBUQUERQUE NM
87111-2310
US

IV. Provider business mailing address

2172 COPELAND RD SW
ALBUQUERQUE NM
87105-6572
US

V. Phone/Fax

Practice location:
  • Phone: 505-462-6400
  • Fax: 505-462-6452
Mailing address:
  • Phone: 505-249-2820
  • Fax: 505-462-6567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberR44779
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: