Healthcare Provider Details

I. General information

NPI: 1225751050
Provider Name (Legal Business Name): ELMIRA L NIXON-TOWNSEND REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2022
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8726 WOODWARD AVE
DETROIT MI
48202-2135
US

IV. Provider business mailing address

4646 JOHN R ST
DETROIT MI
48201-1916
US

V. Phone/Fax

Practice location:
  • Phone: 734-642-6587
  • Fax:
Mailing address:
  • Phone: 313-576-4712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number4704194296
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: