Osullivan, Tim B

Osullivan, Tim B is an individual health care provider with primary practice located at 4444 Gregory Dr , Maumee OH 43537-1822. He recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as his primary health care specialty. Osullivan, Tim B can be contacted via phone (419) 893-7606.

Contact Information

Primary practice address
4444 Gregory Dr Maumee OH 43537-1822
Phone: (419) 893-7606
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 154376 Ohio
Nursing Service Providers / Registered Nurse 163W00000X RN154376 Ohio

Profile Details

NPI number 1538169792
LBN Legal business name Osullivan, Tim B
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2005
Last updated Mar 19th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538169792 NPPES
Ohio Other P00186819 RRMC
Ohio Other 000000379377 RRMC
Ohio MEDICAID 2346634 RRMC

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