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General NPI Number Information
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NPI Number | 1659717825
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Entity Type | Individual
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Provider Name | JACQUELINE M TOWARNICKI RN, NP-C, WHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/15/2013
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Last Update Date | 09/17/2020
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Provider Practice Location Address
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Address Line | 401 RAILROAD ST W
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City | MISSOULA
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State | MT
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Zip | 59802-4109
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Country | US
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Telephone | 406-258-4123
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Fax |
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Provider Business Mailing Address
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Address Line | 401 RAILROAD ST W
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City | MISSOULA
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State | MT
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Zip | 59802-4109
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Country | US
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Telephone | 808-388-2006
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 102929
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 63952
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 102930
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License Number State | MT
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Taxonomy #4
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | CNP131090
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License Number State | ME
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Taxonomy #5
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | CNP131090
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License Number State | ME
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