Provider Demographics
NPI:1265078547
Name:TOWNLEY, JESSICA T (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:T
Last Name:TOWNLEY
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8875 HIGHWAY 112
Mailing Address - Street 2:
Mailing Address - City:GLENMORA
Mailing Address - State:LA
Mailing Address - Zip Code:71433-6223
Mailing Address - Country:US
Mailing Address - Phone:318-308-4815
Mailing Address - Fax:
Practice Address - Street 1:425 SCOTT ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-8131
Practice Address - Country:US
Practice Address - Phone:318-445-7355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA208786363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily