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NPI Code Detail

MEDICARE: JAMIE LYNNE VAILTOWNSEND CHW

MEDICARE: JAMIE LYNNE VAILTOWNSEND CHW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health Worker175319668MI

General Provider Information

NPI Number : 1407794076
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE LYNNE VAILTOWNSEND CHW
Provider Business Mailing Address
First Line : 2316 S CEDAR ST
Second Line :
City : LANSING
State : MI
Zip : 48910-3152
Country : US
Telephone Number : 517-887-4302
Fax Number : 517-887-4437
Provider Business Practice Location Address
First Line : 2316 S CEDAR ST
Second Line :
City : LANSING
State : MI
Zip : 48910-3152
Country : US
Telephone Number : 517-887-4302
Fax Number : 517-887-4437
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2026
Last Update Date : 03/24/2026

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Directions to “ JAMIE LYNNE VAILTOWNSEND CHW” Practice Location

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