Provider Demographics
NPI:1821714197
Name:TOWNSEND, DEVAUGHN
Entity Type:Individual
Prefix:MR
First Name:DEVAUGHN
Middle Name:
Last Name:TOWNSEND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 FOUNTAIN SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-4665
Mailing Address - Country:US
Mailing Address - Phone:330-717-2755
Mailing Address - Fax:
Practice Address - Street 1:1650 FOUNTAIN SQUARE DR
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-4665
Practice Address - Country:US
Practice Address - Phone:330-717-2755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide