Provider Demographics
NPI:1932764222
Name:HAREN, TIMOTHY SEAN (PA-C)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:SEAN
Last Name:HAREN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:NA
Other - Middle Name:NA
Other - Last Name:NA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:60 LIVINGSTON ST STE 200
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4400
Mailing Address - Country:US
Mailing Address - Phone:828-253-4851
Mailing Address - Fax:828-252-1969
Practice Address - Street 1:60 LIVINGSTON ST STE 200
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4400
Practice Address - Country:US
Practice Address - Phone:828-253-4851
Practice Address - Fax:828-252-1969
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA201572363A00000X
NC0010-11974363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant