Provider Demographics
NPI:1669489811
Name:TIMBROOK, CLAUDIA LYNNE (BSN MSN RN FNP-C)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:LYNNE
Last Name:TIMBROOK
Suffix:
Gender:F
Credentials:BSN MSN RN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 SHELBY 420
Mailing Address - Street 2:
Mailing Address - City:LENTNER
Mailing Address - State:MO
Mailing Address - Zip Code:63450-3030
Mailing Address - Country:US
Mailing Address - Phone:660-699-3779
Mailing Address - Fax:660-699-3723
Practice Address - Street 1:6000 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:HANNIBAL
Practice Address - State:MO
Practice Address - Zip Code:63401
Practice Address - Country:US
Practice Address - Phone:180-084-5845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO121003363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP02001Medicare UPIN