Individual provider · Type 1 NPI
Timothy Wayne Mansouri, NURSE PRACTITIONER
Pain Management Registered Nurse · Folsom, CA
NPI number
1770970899
Active
Practice location
1600 Creekside Dr Ste 2400
Folsom, CA 95630-3485
Mailing address
8732 Flute Cir
Elk Grove, CA 95757-1742
Other practice locations
- 1665 Creekside Dr Ste 100, Folsom, CA 95630-3538 · (916) 932-4163
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pain Management Registered Nurse | 163WP0000X | 656576 (CA) |
| Pain Management Registered Nurse Primary | 163WP0000X | 95003073 (CA) |
Pain Management Registered Nurse: Definition to come...
About NPI 1770970899
Timothy Wayne Mansouri, NURSE PRACTITIONER's National Provider Identifier is 1770970899, issued on Apr 16, 2015. The primary taxonomy on file is Pain Management Registered Nurse (163WP0000X), and the practice location is in Folsom, CA. The record was last updated on Mar 3, 2020.