Most Relevant Information
Provider Data
| NPI Number: | 1003418658 |
| Provider Name: | KYLIE MARIE TIMMERMAN RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163WC1500X |
| Specialty: | Registered Nurse |
| License Number: | 95133062 |
Most Important Dates
| Enumeration Date: | 11/09/2020 |
| Last Updated: | 11/09/2020 |
Provider Practice Location
1350 E MAIN ST
GRASS VALLEY
CA
959455208
Practice Location Phone/Fax
| Phone: | 5304779532 |
| Fax: |
Provider Mailing Location
463 BUCKEYE ST
VACAVILLE
CA
956882630
Provider Mailing Phone/Fax
| Phone: | 7073654694 |
| Fax: |