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General NPI Number Information
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NPI Number | 1114086485
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Entity Type | Individual
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Provider Name | DEBORAH DAVIS MULLIGAN-TIMER FNP-BC, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 2452 ROUTE 9 SUITE 205
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City | MALTA
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State | NY
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Zip | 12020
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Country | US
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Telephone | 518-245-3837
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Fax | 518-248-3840
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Provider Business Mailing Address
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Address Line | 646 N SHORE RD PECK LK
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City | GLOVERSVILLE
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State | NY
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Zip | 12078-7017
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Country | US
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Telephone | 518-339-7930
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F333669-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F401249-1
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License Number State | NY
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