Healthcare Provider Details

I. General information

NPI: 1194668046
Provider Name (Legal Business Name): JAZMINE TOWNSEND DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 11TH AVE S STE 24
GREAT FALLS MT
59405-5263
US

IV. Provider business mailing address

PO BOX 6010
GREAT FALLS MT
59406-6010
US

V. Phone/Fax

Practice location:
  • Phone: 406-771-6300
  • Fax: 406-731-8318
Mailing address:
  • Phone: 406-455-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number173588
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: