MEDICARE: MS. ANGELA MICHELLE TIMPSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376J00000X	Homemaker
2	372500000X	Chore Provider

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	384287128	OTHER	OH	GIFTED HANDS CLEANING LLC

General Provider Information

NPI Number	:	1023839750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANGELA MICHELLE TIMPSON

Provider Business Mailing Address
First Line	:	2446 CATALPA DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45406-2155
Country	:	US
Telephone Number	:	937-668-3986
Fax Number	:

Provider Business Practice Location Address
First Line	:	2446 CATALPA DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45406-2155
Country	:	US
Telephone Number	:	937-668-3986
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2024
Last Update Date	:	10/24/2024

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