Provider Demographics
NPI:1932742210
Name:BARNES, TIMOTHY JOSEPH (PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JOSEPH
Last Name:BARNES
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1300 E A ST STE 101
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2211
Mailing Address - Country:US
Mailing Address - Phone:307-224-2484
Mailing Address - Fax:307-222-7784
Practice Address - Street 1:1617 EVANS AVE APT 1
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-4698
Practice Address - Country:US
Practice Address - Phone:307-224-2484
Practice Address - Fax:307-222-7784
Is Sole Proprietor?:No
Enumeration Date:2019-10-19
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY44827363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health