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General NPI Number Information
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NPI Number | 1154053528
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Entity Type | Individual
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Provider Name | ANDREW CALEB TOWNLEY FNP-C
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Gender | Male
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Dates
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Enumeration Date | 06/25/2022
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Last Update Date | 12/22/2023
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Provider Practice Location Address
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Address Line | 1292 W MILL ST
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City | SAN BERNARDINO
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State | CA
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Zip | 92410-2551
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Country | US
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Telephone | 909-253-0841
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Fax |
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Provider Business Mailing Address
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Address Line | 17084 GRAY PINE PL
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City | SAN BERNARDINO
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State | CA
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Zip | 92407-1525
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Country | US
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Telephone | 318-792-2410
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95021038
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License Number State | CA
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