Provider Demographics
NPI:1750390431
Name:ARTHUR, TIMOTHY L (CRNA)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:L
Last Name:ARTHUR
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1423 7TH ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:NE
Mailing Address - Zip Code:68818-1141
Mailing Address - Country:US
Mailing Address - Phone:402-694-3171
Mailing Address - Fax:402-694-5024
Practice Address - Street 1:1423 7TH ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:NE
Practice Address - Zip Code:68818-1141
Practice Address - Country:US
Practice Address - Phone:402-694-3171
Practice Address - Fax:402-694-5024
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE100367367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE271371 ARMedicare ID - Type UnspecifiedMEDICARE B NUMBER