Provider Demographics
NPI:1497840847
Name:TOWNSEND, TIFFANY L (FNP-C)
Entity type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:L
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BRAMHALL ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102
Mailing Address - Country:US
Mailing Address - Phone:207-662-2216
Mailing Address - Fax:207-662-6392
Practice Address - Street 1:78 ATLANTIC PL
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-2316
Practice Address - Country:US
Practice Address - Phone:207-842-7736
Practice Address - Fax:207-842-7773
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP081485363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily