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General NPI Number Information
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NPI Number | 1063540789
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Entity Type | Individual
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Provider Name | SUSAN TIMAN CNS
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Gender | Female
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 12/23/2011
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Provider Practice Location Address
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Address Line | 700 CHILDRENS DR
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City | COLUMBUS
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State | OH
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Zip | 43205-2664
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Country | US
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Telephone | 614-722-8212
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Fax | 614-722-3235
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Provider Business Mailing Address
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Address Line | PO BOX 715194
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City | COLUMBUS
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State | OH
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Zip | 43271-5194
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Country | US
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Telephone | 614-355-8004
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Fax | 614-355-0509
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | RN166338
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License Number State | OH
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