Provider Demographics
NPI:1609386085
Name:TIMMONS, MATTHEW DANIEL (RNFA)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:DANIEL
Last Name:TIMMONS
Suffix:
Gender:M
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5742 FOUR SEASONS LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-3048
Mailing Address - Country:US
Mailing Address - Phone:209-988-5636
Mailing Address - Fax:
Practice Address - Street 1:5742 FOUR SEASONS LN
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-3048
Practice Address - Country:US
Practice Address - Phone:209-988-5636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX897475163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant