Healthcare Provider Details

I. General information

NPI: 1336053214
Provider Name (Legal Business Name): DANIELLE MONIQUE TOWNSEND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5954 ANDOVER RD
INDIANAPOLIS IN
46220-5321
US

IV. Provider business mailing address

5954 ANDOVER RD
INDIANAPOLIS IN
46220-5321
US

V. Phone/Fax

Practice location:
  • Phone: 463-212-3690
  • Fax:
Mailing address:
  • Phone: 463-212-3690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number260176871
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: