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NPI Code Detail

MEDICARE: MARCIA LANETTE TIMMONS FNP

MEDICARE: MARCIA LANETTE TIMMONS FNP
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
1363L00000XNurse Practitioner31506SC
2363L00000XNurse PractitionerAPRN11026894FL
3363L00000XNurse PractitionerRN208133GA
4363L00000XNurse Practitioner1235458TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1F06193081OTHERGANP CERTIFICATION NUMBER
2RN208133OTHERGAFNP LICENSE

General Provider Information

NPI Number : 1336792886
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCIA LANETTE TIMMONS FNP
Provider Business Mailing Address
First Line : 105 CARNEGIE PL STE 103
Second Line :
City : FAYETTEVILLE
State : GA
Zip : 30214-5900
Country : US
Telephone Number : 770-716-7999
Fax Number : 770-716-8444
Provider Business Practice Location Address
First Line : 105 CARNEGIE PL STE 103
Second Line :
City : FAYETTEVILLE
State : GA
Zip : 30214-5900
Country : US
Telephone Number : 770-716-7999
Fax Number : 770-716-8444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2019
Last Update Date : 05/26/2026

Similar Medicare Providers

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Practice Location Address:
105 CARNEGIE PL STE 103
FAYETTEVILLE, GA
30214-5900
Practice Phone: 770-716-7999
Practice Fax: 770-716-8444
1841438520 — DR. NATASHA ALTINA STINSON M.D.
Practice Location Address:
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Practice Fax:
1922238260 — FRANCES MARIE LANDRUM FNP-C
Practice Location Address:
105 CARNEGIE PL STE 103
FAYETTEVILLE, GA
30214-5900
Practice Phone: 770-716-7999
Practice Fax: 770-716-8444
1245785013 — AMANDA SULLIVAN BAHLER APRN
Practice Location Address:
105 CARNEGIE PL STE 103
FAYETTEVILLE, GA
30214-5900
Practice Phone: 770-716-7999
Practice Fax: 770-716-8444
1063956431 — JERRICA MILES PA-C
Practice Location Address:
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FAYETTEVILLE, GA
30214-5900
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1659899375 — CHELSEA DAWN MALINOWSKI
Practice Location Address:
105 CARNEGIE PL STE 103
FAYETTEVILLE, GA
30214-5900
Practice Phone: 770-716-7999
Practice Fax: 770-716-8444

Directions to “ MARCIA LANETTE TIMMONS FNP” Practice Location

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