Provider Demographics
NPI:1396840120
Name:TIMMINS, CHRISTOPHER LOUIS (APRN)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:LOUIS
Last Name:TIMMINS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 932958
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-4431
Mailing Address - Country:US
Mailing Address - Phone:888-852-2567
Mailing Address - Fax:
Practice Address - Street 1:12450 LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-1901
Practice Address - Country:US
Practice Address - Phone:502-638-4783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012446363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
111832OtherMEDICARE PTAN
GARN202115NPOtherLICENSE
GA403251185EMedicaid
GRP 1855OtherMEDICARE GROUP PTAN