Provider Demographics
NPI:1578604609
Name:TOWNSEND, HEATHER MARIE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:MARIE
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37008 FORESTDEL DR
Mailing Address - Street 2:
Mailing Address - City:EUSTIS
Mailing Address - State:FL
Mailing Address - Zip Code:32736-7907
Mailing Address - Country:US
Mailing Address - Phone:407-718-9730
Mailing Address - Fax:321-274-0246
Practice Address - Street 1:483 N SEMORAN BLVD
Practice Address - Street 2:STE 102
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3800
Practice Address - Country:US
Practice Address - Phone:407-645-1847
Practice Address - Fax:321-274-0246
Is Sole Proprietor?:No
Enumeration Date:2007-02-10
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 3303772363LF0000X
GARN102612 NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE3735TOtherMEDICARE PTAN
FLP00977Medicare UPIN