Provider Demographics
NPI:1912372947
Name:TIMONEY, JACLYN MARIE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:JACLYN
Middle Name:MARIE
Last Name:TIMONEY
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Gender:F
Credentials:CRNP
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Mailing Address - Street 1:1648 HUNTINGDON PIKE
Mailing Address - Street 2:MEDICAL STAFF OFFICE 1ST FLR
Mailing Address - City:MEADOWBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19046-8001
Mailing Address - Country:US
Mailing Address - Phone:215-938-3450
Mailing Address - Fax:215-938-3829
Practice Address - Street 1:23 BUSTLETON PIKE STE 200
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6446
Practice Address - Country:US
Practice Address - Phone:215-938-3450
Practice Address - Fax:215-938-3829
Is Sole Proprietor?:No
Enumeration Date:2015-12-02
Last Update Date:2021-07-08
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Provider Licenses
StateLicense IDTaxonomies
PASP015325363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA482951SSSMedicare PIN