Provider Demographics
NPI:1285189969
Name:LAMBERT, TIMOTHY HEATH (CRNA)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:HEATH
Last Name:LAMBERT
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 BISHOPS PARK DR UNIT 308
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27605-1250
Mailing Address - Country:US
Mailing Address - Phone:336-944-2205
Mailing Address - Fax:
Practice Address - Street 1:700 BISHOPS PARK DR UNIT 308
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27605-1250
Practice Address - Country:US
Practice Address - Phone:336-944-2205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC113382367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered