Healthcare Provider Details

I. General information

NPI: 1093733123
Provider Name (Legal Business Name): CATHERINE TIMKO CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 12/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34TH AND CIVIC CENTER BLVD CHILDREN'S HOSPITAL OF PHILADELPHIA
PHILADELPHIA PA
19104
US

IV. Provider business mailing address

4034 WOODRUFF RD
LAFAYETTE HILL PA
19444-1618
US

V. Phone/Fax

Practice location:
  • Phone: 267-426-9298
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberTP-006780-D
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: