Provider Demographics
NPI:1790007433
Name:THORNHILL, TIMIKO C (MSN,RN, FNP-BC, CNOR)
Entity type:Individual
Prefix:MS
First Name:TIMIKO
Middle Name:C
Last Name:THORNHILL
Suffix:
Gender:F
Credentials:MSN,RN, FNP-BC, CNOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1670 CLAIRMONT RD
Mailing Address - Street 2:2ND FLOOR OPERATING ROOM
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-2841
Mailing Address - Country:US
Mailing Address - Phone:770-656-1672
Mailing Address - Fax:
Practice Address - Street 1:5546 ROSSER RD
Practice Address - Street 2:
Practice Address - City:SMOKE RISE
Practice Address - State:GA
Practice Address - Zip Code:30087-1240
Practice Address - Country:US
Practice Address - Phone:770-656-1672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN177248163W00000X, 163WR0006X, 163WS0121X, 363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Multi-Specialty
No163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty