Timothy, Marie R.

Timothy, Marie R. is an sole proprietor health care provider with primary practice located at 1750 E 3100 N , Layton UT 84040-2406. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Timothy, Marie R. can be contacted via phone (801) 773-4840.

Contact Information

Primary practice address
1750 E 3100 N Layton UT 84040-2406
Phone: (801) 773-4840
Fax: (801) 525-3164
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 327899-4405 Utah
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 327899-4405 Utah

Profile Details

NPI number 1124676044
LBN Legal business name Timothy, Marie R.
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 4th, 2019
Last updated Dec 19th, 2024 - about 2 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 1124676044 NPPES
Utah Other 000055266 MEDICARE PIN
Utah MEDICAID 8760003008007 MEDICARE PIN
Utah Other 260022408 MEDICARE PIN
Utah MEDICAID U000113063 MEDICARE PIN

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