MEDICARE: STEPHANIE MACMILLAN TIMMONS APRN

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	163W00000X	Registered Nurse	RN. 308737	OH
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP.09017	OH

General Provider Information

NPI Number	:	1194816934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE MACMILLAN TIMMONS APRN

Provider Business Mailing Address
First Line	:	112 MICHIGAN DR
Second Line	:
City	:	TERRACE PARK
State	:	OH
Zip	:	45174-1148
Country	:	US
Telephone Number	:	513-226-2300
Fax Number	:

Provider Business Practice Location Address
First Line	:	2570 MADISON RD
Second Line	:	APT. 13
City	:	CINCINNATI
State	:	OH
Zip	:	45208-1157
Country	:	US
Telephone Number	:	513-226-2300
Fax Number	:

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

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	02/16/2026

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