Provider Demographics
NPI:1598780843
Name:TIMLICK, PATRICIA E (FNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:E
Last Name:TIMLICK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4524 N MARYVALE PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85031-1732
Mailing Address - Country:US
Mailing Address - Phone:623-846-6653
Mailing Address - Fax:623-846-0220
Practice Address - Street 1:4524 N MARYVALE PKWY STE 220
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85031-1732
Practice Address - Country:US
Practice Address - Phone:623-846-6653
Practice Address - Fax:623-846-0220
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN084815363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily