Provider Demographics
NPI:1952696676
Name:TIMONEY, NESSA S (MBBCH)
Entity Type:Individual
Prefix:
First Name:NESSA
Middle Name:S
Last Name:TIMONEY
Suffix:
Gender:F
Credentials:MBBCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2701
Mailing Address - Country:US
Mailing Address - Phone:859-258-6200
Mailing Address - Fax:859-258-6503
Practice Address - Street 1:1401 HARRODSBURG RD STE A540
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-1720
Practice Address - Country:US
Practice Address - Phone:270-780-2660
Practice Address - Fax:270-780-2692
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY51603207T00000X
KYR2655207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100246120Medicaid