Primrose, Timothy

Primrose, Timothy is an individual health care provider with primary practice located at 5215 Holy Cross Pkwy , Mishawaka IN 46545-1469. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Neonatal. Physician Assistants & Advanced Practice Nursing Providers / Neonatal is his primary health care specialty. Primrose, Timothy can be contacted via phone (574) 335-4145.

Contact Information

Primary practice address
5215 Holy Cross Pkwy Mishawaka IN 46545-1469
Phone: (574) 335-4145
Fax: (574) 335-4146
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71005880A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X 71005880A Indiana

Profile Details

NPI number 1578934402
LBN Legal business name Primrose, Timothy
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2015
Last updated Mar 27th, 2024 - about last year

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 1578934402 NPPES
Indiana Other 000000969840 BCBS
Indiana MEDICAID 201327760 BCBS

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