Provider Demographics
NPI:1790077550
Name:TOWNSEND, ELIZABETH (RN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:TOWNSEND
Other - Last Name:MOUROUZIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:1 WYOMING ST
Mailing Address - Street 2:CENTER FOR WOMEN'S HEALTHCARE
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409
Mailing Address - Country:US
Mailing Address - Phone:937-208-2007
Mailing Address - Fax:937-208-2752
Practice Address - Street 1:1 WYOMING ST
Practice Address - Street 2:CENTER FOR WOMEN'S HEALTHCARE
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409
Practice Address - Country:US
Practice Address - Phone:937-208-2007
Practice Address - Fax:937-208-2752
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH219958261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)