Provider Demographics
NPI:1639821036
Name:WOOD, TIMOTHY WILLIAM (PMHNP-BC)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:WILLIAM
Last Name:WOOD
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7050 S FILLMORE CT
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-1834
Mailing Address - Country:US
Mailing Address - Phone:860-309-4283
Mailing Address - Fax:
Practice Address - Street 1:7050 S FILLMORE CT
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-1834
Practice Address - Country:US
Practice Address - Phone:860-309-4283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0997299-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health