Provider Demographics
NPI:1841497294
Name:THIMGAN, BARBARA (RN)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:
Last Name:THIMGAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LA JUNTA
Mailing Address - State:CO
Mailing Address - Zip Code:81050-1536
Mailing Address - Country:US
Mailing Address - Phone:719-383-3040
Mailing Address - Fax:719-383-3060
Practice Address - Street 1:13 W 3RD ST
Practice Address - Street 2:ROOM 111
Practice Address - City:LA JUNTA
Practice Address - State:CO
Practice Address - Zip Code:81050-1536
Practice Address - Country:US
Practice Address - Phone:719-383-3040
Practice Address - Fax:719-383-3060
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO45261163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07452618Medicaid