Provider Demographics
NPI:1326463100
Name:TIMMER, DONNA L (RN,BSN,IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:L
Last Name:TIMMER
Suffix:
Gender:F
Credentials:RN,BSN,IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 CEDAR TERRACE CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-5884
Mailing Address - Country:US
Mailing Address - Phone:832-451-2687
Mailing Address - Fax:
Practice Address - Street 1:1319 CEDAR TERRACE CT
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-5884
Practice Address - Country:US
Practice Address - Phone:832-451-2687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX698545163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant