Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TIMOTHY WAYNE MANSOURI, NURSE PRACTITIONER
Active Sole ProprietorTIMOTHY WAYNE MANSOURI, NURSE PRACTITIONER is a Pain Management Nurse healthcare provider located in FOLSOM, California. NPI 1770970899 is currently active in the NPPES registry. Verify at CMS.
Pain Management Nurse · FOLSOM, CA
Registration Details
- NPI Number
- 1770970899
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 16, 2015 (11.354862860001 yrs)
- Last Updated
- Mar 3, 2020
- Licenses
-
656576 (CA)95003073 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1600 CREEKSIDE DR STE 2400FOLSOM, CA, 956303485Browse CA providers · Browse ZIP 95630
- Phone
- 9169324163
- Primary Specialty
-
Pain Management Nurse
163WP0000X
- Additional Specialty
- Pain Management Nurse
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.