Provider Demographics
NPI:1659966521
Name:TOWNSEND, CARLYE MORGAN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CARLYE
Middle Name:MORGAN
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:CARLYE
Other - Middle Name:MORGAN
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1160 S WILDFIRE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-5966
Mailing Address - Country:US
Mailing Address - Phone:515-707-7411
Mailing Address - Fax:
Practice Address - Street 1:1801 HICKMAN RD
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-1597
Practice Address - Country:US
Practice Address - Phone:515-282-2423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2022-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA115830363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant