Provider Demographics
NPI:1891943973
Name:TIMBREZA, KAY ELAINE (NNP)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:ELAINE
Last Name:TIMBREZA
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:KAY
Other - Middle Name:ELAINE
Other - Last Name:HENRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1126 GARDEN CLUB WAY
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-4133
Mailing Address - Country:US
Mailing Address - Phone:910-232-0190
Mailing Address - Fax:
Practice Address - Street 1:1126 GARDEN CLUB WAY
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:NC
Practice Address - Zip Code:28451-4133
Practice Address - Country:US
Practice Address - Phone:910-232-0190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC157861363LN0005X
TX541723363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care