Healthcare Provider Details

I. General information

NPI: 1881079614
Provider Name (Legal Business Name): DEBORAH L TOWNSLEY APRN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBORAH L SPURLOCK FNP

II. Dates (important events)

Enumeration Date: 07/22/2015
Last Update Date: 10/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 MAIN ST
MADISON WV
25130-1417
US

IV. Provider business mailing address

97 GREAT TEAYS BLVD STE 6
SCOTT DEPOT WV
25560-9815
US

V. Phone/Fax

Practice location:
  • Phone: 304-369-0393
  • Fax: 304-369-0371
Mailing address:
  • Phone: 304-757-6999
  • Fax: 304-201-5019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number56889
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN56889FNPBC
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: