Provider Demographics
NPI:1558183814
Name:HARRIS TOWNSEND, TAJAE (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:TAJAE
Middle Name:
Last Name:HARRIS TOWNSEND
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11025 SW 168TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-0305
Mailing Address - Country:US
Mailing Address - Phone:305-586-0080
Mailing Address - Fax:
Practice Address - Street 1:11025 SW 168TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-0305
Practice Address - Country:US
Practice Address - Phone:305-586-0080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11035511363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily