Provider Demographics
NPI:1982127643
Name:MCGHEE, TIMOTHY LEE (FNP-C)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:LEE
Last Name:MCGHEE
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5372 N LONG RIFLE RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-4215
Mailing Address - Country:US
Mailing Address - Phone:623-666-3743
Mailing Address - Fax:928-227-4110
Practice Address - Street 1:5372 N LONG RIFLE RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-4215
Practice Address - Country:US
Practice Address - Phone:623-666-3743
Practice Address - Fax:928-227-4110
Is Sole Proprietor?:No
Enumeration Date:2017-07-24
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP10407363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily