Provider Demographics
NPI:1649944844
Name:TOWNSEND-HARRISON, BANI'CI' NICOSI'A (PMHNP)
Entity type:Individual
Prefix:
First Name:BANI'CI'
Middle Name:NICOSI'A
Last Name:TOWNSEND-HARRISON
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 368
Mailing Address - Street 2:
Mailing Address - City:BUTNER
Mailing Address - State:NC
Mailing Address - Zip Code:27509-0368
Mailing Address - Country:US
Mailing Address - Phone:919-529-2474
Mailing Address - Fax:
Practice Address - Street 1:206 W LAKE RD
Practice Address - Street 2:SUITE C
Practice Address - City:CREEDMOOR
Practice Address - State:NC
Practice Address - Zip Code:27522
Practice Address - Country:US
Practice Address - Phone:919-368-6318
Practice Address - Fax:919-980-9321
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-03
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC271633163WP0808X
NC5014990363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health