Provider Demographics
NPI:1275029928
Name:TOWNSEND, STACY (CNP)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 REYNOLDS WAY
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45430-1586
Mailing Address - Country:US
Mailing Address - Phone:937-485-9401
Mailing Address - Fax:937-485-9412
Practice Address - Street 1:1 REYNOLDS WAY
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45430-1586
Practice Address - Country:US
Practice Address - Phone:937-485-9401
Practice Address - Fax:937-485-9412
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.023071363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care