Mudge, Timothy A

Mudge, Timothy A is an individual health care provider with primary practice located at 2080 W Arlington Blvd Ste B , Greenville NC 27834-3770. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, Nursing Service Providers / Registered Nurse. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Mudge, Timothy A can be contacted via phone (252) 752-2140.

Contact Information

Primary practice address
2080 W Arlington Blvd Ste B Greenville NC 27834-3770
Phone: (252) 752-2140
Fax: (252) 689-6502
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 035818 North Carolina
Nursing Service Providers / Registered Nurse 163W00000X 074797 North Carolina

Profile Details

NPI number 1578603718
LBN Legal business name Mudge, Timothy A
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2007
Last updated Oct 11th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578603718 NPPES
North Carolina Other 1578603718 TRICARE
North Carolina MEDICAID 8050470 TRICARE
North Carolina Other P00343914 TRICARE

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