Provider Demographics
NPI:1194505784
Name:TOWNER, JENNIFER LYN
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYN
Last Name:TOWNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 DIAMOND CT
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-2556
Mailing Address - Country:US
Mailing Address - Phone:567-277-0642
Mailing Address - Fax:
Practice Address - Street 1:117 DIAMOND CT
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-2556
Practice Address - Country:US
Practice Address - Phone:567-277-0642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker