Pellegrin, Timothy J

Pellegrin, Timothy J is an individual health care provider with primary practice located at 1014 W Tunnel Blvd , Houma LA 70360-4050. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as his primary health care specialty. Pellegrin, Timothy J can be contacted via phone (985) 851-1717.

Contact Information

Primary practice address
1014 W Tunnel Blvd Houma LA 70360-4050
Phone: (985) 851-1717
Fax: (985) 868-3839
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X APO4222 Louisiana

Profile Details

NPI number 1134160815
LBN Legal business name Pellegrin, Timothy J
Credentials PMHNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2006
Last updated Jun 17th, 2022 - about 4 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 1134160815 NPPES
Louisiana Other 4C669 MEDICARE NUMBER
Louisiana MEDICAID 1152919 MEDICARE NUMBER
Louisiana Other 568555 MEDICARE NUMBER

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