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General NPI Number Information
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NPI Number | 1699094623
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Entity Type | Individual
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Provider Name | TIMOTHY J LORD ARNP
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Gender | Male
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Dates
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Enumeration Date | 06/01/2010
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Last Update Date | 11/23/2015
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Provider Practice Location Address
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Address Line | 560 GAGE BLVD STE 102 KADLEC CLINIC SENIOR HEALTH CLINIC
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City | RICHLAND
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State | WA
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Zip | 99352
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Country | US
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Telephone | 509-942-3135
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Fax | 509-627-1188
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Provider Business Mailing Address
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Address Line | 560 GAGE BLVD STE 203
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City | RICHLAND
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State | WA
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Zip | 99352
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Country | US
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Telephone | 509-942-3627
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Fax | 509-942-2268
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | AP30004092
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201050071NP
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License Number State | OR
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