Provider Demographics
NPI:1689385056
Name:TOWNLEY, LEAH MICHELLE (RN)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:MICHELLE
Last Name:TOWNLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 734
Mailing Address - Street 2:
Mailing Address - City:MOORCROFT
Mailing Address - State:WY
Mailing Address - Zip Code:82721
Mailing Address - Country:US
Mailing Address - Phone:443-553-9433
Mailing Address - Fax:
Practice Address - Street 1:300 EAST WESTON ST.
Practice Address - Street 2:
Practice Address - City:MOORCROFT
Practice Address - State:WY
Practice Address - Zip Code:82721
Practice Address - Country:US
Practice Address - Phone:443-553-9433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-07
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY48216163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse