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NPI Code Detail

MEDICARE: MRS. CONNIE SUE TOWNSEND FNP

MEDICARE: MRS. CONNIE SUE TOWNSEND FNP
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
1363L00000XNurse Practitioner71000162AIN

General Provider Information

NPI Number : 1497744312
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CONNIE SUE TOWNSEND FNP
Provider Business Mailing Address
First Line : 1214 CHENOWETH LN
Second Line :
City : W LAFAYETTE
State : IN
Zip : 47906-8527
Country : US
Telephone Number : 765-583-2126
Fax Number :
Provider Business Practice Location Address
First Line : 1466 W OAK ST
Second Line :
City : ZIONSVILLE
State : IN
Zip : 46077-1800
Country : US
Telephone Number : 317-873-6438
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2005
Last Update Date : 01/13/2009

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