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NPI Code Detail

MEDICARE: JULIE LYNN TIMMERMAN CRNA

MEDICARE: JULIE LYNN TIMMERMAN CRNA
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
1367500000XCertified Registered Nurse Anesthetist720416TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18874UGOTHERTXBCBS
2P01338248OTHERTXRR
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619991676
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE LYNN TIMMERMAN CRNA
Provider Business Mailing Address
First Line : PO BOX 650865
Second Line :
City : DALLAS
State : TX
Zip : 75265-0865
Country : US
Telephone Number : 972-715-5000
Fax Number : 972-715-9976
Provider Business Practice Location Address
First Line : 1000 LIPSCOMB ST STE 110
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-3181
Country : US
Telephone Number : 817-348-8600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 09/10/2020

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Directions to “ JULIE LYNN TIMMERMAN CRNA” Practice Location

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