Healthcare Provider Details

I. General information

NPI: 1750217618
Provider Name (Legal Business Name): JENNIFER TOWLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 MCAULEY DR
YPSILANTI MI
48197-1051
US

IV. Provider business mailing address

5301 MCAULEY DR
YPSILANTI MI
48197-1051
US

V. Phone/Fax

Practice location:
  • Phone: 734-712-4566
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License Number4704313099
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: