Provider Demographics
NPI:1194801001
Name:TIMMONS, NIKOL DEEM (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:MRS
First Name:NIKOL
Middle Name:DEEM
Last Name:TIMMONS
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
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Mailing Address - Street 1:PO BOX 360
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-0360
Mailing Address - Country:US
Mailing Address - Phone:888-339-6065
Mailing Address - Fax:828-538-4441
Practice Address - Street 1:6051 TYVOLA GLEN CIR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-6431
Practice Address - Country:US
Practice Address - Phone:704-774-6569
Practice Address - Fax:855-308-2340
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2025-11-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC101627363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8101457Medicaid
NC70056PMedicare UPIN