Provider Demographics
NPI:1477011500
Name:ZAMULINSKI, TIMOTHY GRAHAM (MSN, AGACNP-BC, RN)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:GRAHAM
Last Name:ZAMULINSKI
Suffix:
Gender:M
Credentials:MSN, AGACNP-BC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16252 FAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77303-2010
Mailing Address - Country:US
Mailing Address - Phone:979-450-5220
Mailing Address - Fax:
Practice Address - Street 1:27800 HIGHWAY 290
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-5302
Practice Address - Country:US
Practice Address - Phone:979-450-5220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-07
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140873363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care