Provider Demographics
NPI:1952010829
Name:TOWNSEND, STEPHANIE MARANN (LPN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MARANN
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 MIDDLE PATCH RD
Mailing Address - Street 2:
Mailing Address - City:GALLAGHER
Mailing Address - State:WV
Mailing Address - Zip Code:25083-8007
Mailing Address - Country:US
Mailing Address - Phone:304-389-4009
Mailing Address - Fax:
Practice Address - Street 1:475 MIDDLE PATCH RD
Practice Address - Street 2:
Practice Address - City:GALLAGHER
Practice Address - State:WV
Practice Address - Zip Code:25083-8007
Practice Address - Country:US
Practice Address - Phone:304-389-4009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV38312164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse