Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Timothy Paul Kordick, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1174796601

Timothy Paul Kordick, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Poplar Bluff, Missouri. Qualified in 2002, 24 years ago. Practices with Rural Health Pain Management LLC, a 36-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
24
Licensed in
MO
In the registry since
2008
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2620 N Westwood Blvd
Poplar Bluff, MO 63901-3396
Phone: (573) 686-4111
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 2004031215 (MO)

Record details

NPI number1174796601
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedApril 4, 2008
Last updated in NPPESApril 4, 2008

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Rural Health Pain Management Llc — 36 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Poplar Bluff