Provider Demographics
NPI:1053022954
Name:TIMM, CHRISTINA (APRN, CNP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:TIMM
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 2ND ST SE STE A
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56345-3558
Mailing Address - Country:US
Mailing Address - Phone:320-631-7000
Mailing Address - Fax:320-631-7229
Practice Address - Street 1:811 2ND ST SE STE A
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56345-3558
Practice Address - Country:US
Practice Address - Phone:320-631-7000
Practice Address - Fax:320-631-7229
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9803363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health