Provider Demographics
NPI:1194972406
Name:TIMNA, SUSAN (AUD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:TIMNA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 CAROLINE'S RETREAT
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406
Mailing Address - Country:US
Mailing Address - Phone:912-777-8580
Mailing Address - Fax:
Practice Address - Street 1:15 LAKE STREET
Practice Address - Street 2:SUITE 160
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31411
Practice Address - Country:US
Practice Address - Phone:912-777-8580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002062237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA582468197Medicaid
GA3593OtherMEDICARE GROUP #