Provider Demographics
NPI:1104662428
Name:TOWNSEND, DANQUILLA (OWNER)
Entity type:Individual
Prefix:
First Name:DANQUILLA
Middle Name:
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3173 KIRBY WHITTEN RD
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-2881
Mailing Address - Country:US
Mailing Address - Phone:901-428-2905
Mailing Address - Fax:833-829-5135
Practice Address - Street 1:3173 KIRBY WHITTEN RD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-2881
Practice Address - Country:US
Practice Address - Phone:901-428-2905
Practice Address - Fax:833-829-5135
Is Sole Proprietor?:No
Enumeration Date:2024-07-05
Last Update Date:2024-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide