Provider Demographics
NPI:1801859236
Name:TIMBER CREEK CONSULTANTS INC.
Entity Type:Organization
Organization Name:TIMBER CREEK CONSULTANTS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:BATTEN
Authorized Official - Last Name:GLAZER
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:352-378-8934
Mailing Address - Street 1:6434 NW 42ND RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-4280
Mailing Address - Country:US
Mailing Address - Phone:352-378-8934
Mailing Address - Fax:352-372-1169
Practice Address - Street 1:6434 NW 42ND RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-4280
Practice Address - Country:US
Practice Address - Phone:352-378-8934
Practice Address - Fax:352-372-1169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-07
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP450192363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL306748300Medicaid
FLP00209328OtherRR MEDICARE
FLE3107OtherBCBS
FL306748300Medicaid
FL306748300Medicaid