Provider Demographics
NPI:1093989808
Name:TOWNZEN, NANCY ANN (RN, CDE)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ANN
Last Name:TOWNZEN
Suffix:
Gender:F
Credentials:RN, CDE
Other - Prefix:MISS
Other - First Name:NANCY
Other - Middle Name:ANN
Other - Last Name:BLAYLOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CDE
Mailing Address - Street 1:310 W CENTER ST
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:IL
Mailing Address - Zip Code:62012-1134
Mailing Address - Country:US
Mailing Address - Phone:775-229-0101
Mailing Address - Fax:
Practice Address - Street 1:400 MAPLE SUMMIT RD
Practice Address - Street 2:JERSEY COMMUNITY HOSPITAL
Practice Address - City:JERSEYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62052-2028
Practice Address - Country:US
Practice Address - Phone:618-498-8402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN18588163WD0400X
IL041.177498163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV004716904Medicaid