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General NPI Number Information
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NPI Number | 1659940583
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Entity Type | Individual
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Provider Name | TIMOTHY MICHAEL WALSH
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Gender | Male
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Dates
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Enumeration Date | 06/24/2021
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 5309 COMMONWEALTH CENTRE PKWY STE 401
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-2633
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Country | US
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Telephone | 804-465-9311
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Fax | 804-953-9815
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Provider Business Mailing Address
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Address Line | 5309 COMMONWEALTH CENTRE PKWY STE 401
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-2633
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Country | US
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Telephone | 804-465-9311
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Fax | 804-953-9815
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024180507
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License Number State | VA
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