Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | APRN11007253 | FL |
N | 363LA2100X | Nurse Practitioner - Acute Care | APRN11007253 | FL |
NPI | 1013530807 |
---|---|
Provider Name | Timothy James Garrahy |
First Address | Jacksonville, FL 32207-8202 |
Second Address | Jacksonville, FL 32207-8202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2020 |
Last Update Date | 10/11/2020 |