Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 95005167 | CA |
NPI | 1619412780 |
---|---|
Provider Name | Beth Anne Townsend |
First Address | Goleta, CA 93117-2317 |
Second Address | Santa Barbara, CA 93105-4353 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2016 |
Last Update Date | 28/12/2016 |