MEDICARE: NIKKIRA T TOWNSEND CRNP

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
1	363LF0000X	Family Nurse Practitioner	SP029411	PA

General Provider Information

NPI Number	:	1447098231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIKKIRA T TOWNSEND CRNP

Provider Business Mailing Address
First Line	:	PO BOX 198
Second Line	:
City	:	DREXEL HILL
State	:	PA
Zip	:	19026-0198
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 LANCASTER AVE # 100
Second Line	:
City	:	BERWYN
State	:	PA
Zip	:	19312-1710
Country	:	US
Telephone Number	:	610-251-2525
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2024
Last Update Date	:	07/17/2024

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