Provider Demographics
NPI:1871584888
Name:TIMMONS, VERNELL FLOOD (ADULT PSYCH APRN)
Entity type:Individual
Prefix:MRS
First Name:VERNELL
Middle Name:FLOOD
Last Name:TIMMONS
Suffix:
Gender:F
Credentials:ADULT PSYCH APRN
Other - Prefix:
Other - First Name:VERNELL
Other - Middle Name:RENE'
Other - Last Name:FLOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ADULT PSYCH/MENTAL H
Mailing Address - Street 1:367 ATHENS HWY
Mailing Address - Street 2:STE 1050
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-2270
Mailing Address - Country:US
Mailing Address - Phone:770-554-2999
Mailing Address - Fax:678-353-6979
Practice Address - Street 1:5030 GEORGIA BELLE CT STE 2036
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-2667
Practice Address - Country:US
Practice Address - Phone:678-209-2756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN112394163WP0809X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult