Healthcare Provider Details

I. General information

NPI: 1912711367
Provider Name (Legal Business Name): NICOLAS AARON TOWNSEND
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2025
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 S MAIN ST
MILAN OH
44846-9765
US

IV. Provider business mailing address

1210 PELTON PARK LN
SANDUSKY OH
44870-7082
US

V. Phone/Fax

Practice location:
  • Phone: 419-499-2576
  • Fax:
Mailing address:
  • Phone: 330-275-4691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN.453643
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: