Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 26NN0421880 | NJ |
N | 363LP2300X | Nurse Practitioner - Primary Care | SP003714C | PA |
NPI | 1073565222 |
---|---|
Provider Name | Prof. Ann B Townsend |
First Address | Medford, NJ 08055-8507 |
Second Address | Haddon Heights, NJ 08035-1715 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 31/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10735652222 | (02) | |
S57235 | (02) | NJ |