Provider Demographics
NPI:1487204020
Name:TOWNSLEY, LAURIE ANN (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:ANN
Last Name:TOWNSLEY
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29956 COUNTY ROAD 390
Mailing Address - Street 2:
Mailing Address - City:GOBLES
Mailing Address - State:MI
Mailing Address - Zip Code:49055-9260
Mailing Address - Country:US
Mailing Address - Phone:269-271-1426
Mailing Address - Fax:
Practice Address - Street 1:2520 ROBERT JONES WAY
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-1904
Practice Address - Country:US
Practice Address - Phone:269-552-0420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-16
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704188920363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care