TIMOTHY BLAKE BURNHAM FNP
NPI 1598250490
Nurse Practitioner - Family in Unadilla, GA
Active since June 25, 2018
About Timothy Blake Burnham Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TIMOTHY BLAKE BURNHAM FNP (NPI 1598250490) is an individual family provider in Unadilla, Georgia, licensed in Georgia (RN209498) and active in the NPI registry since June 2018.
NPPES Registry Identity
NPI1598250490
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameTIMOTHY BLAKE BURNHAMCredential: FNP
Location Address1412 PLUNKET RDUnadilla, GA 31091-5600
Mailing Address1562 Free Gift Church RdEastman, GA 31023-7420 · (478) 488-0445
Phone(478) 627-2000
Sole ProprietorNo
Enumeration DateJune 25, 2018
✔ NPI 1598250490 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in GA · RN209498
1412 PLUNKET RD, Unadilla, GA 31091
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1598250490, enumerated as an "individual" on June 25, 2018.
The provider is located at 1412 PLUNKET RD UNADILLA, GA 31091 and the phone number is (478) 627-2000.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
