Provider Demographics
NPI:1194179598
Name:TIMBS, SUZAN LANORE (NP)
Entity Type:Individual
Prefix:
First Name:SUZAN
Middle Name:LANORE
Last Name:TIMBS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 S PADRE ISLAND DR
Mailing Address - Street 2:NICU
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-4913
Mailing Address - Country:US
Mailing Address - Phone:361-761-1200
Mailing Address - Fax:361-761-3353
Practice Address - Street 1:7101 S PADRE ISLAND DR
Practice Address - Street 2:NICU
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-4913
Practice Address - Country:US
Practice Address - Phone:361-761-1200
Practice Address - Fax:361-761-3353
Is Sole Proprietor?:No
Enumeration Date:2016-04-21
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP109956363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care