Basic Information
| Provider Information | |||||||||
| NPI: | 1881079614 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TOWNSLEY | ||||||||
| FirstName: | DEBORAH | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | APRN, RN | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SPURLOCK | ||||||||
| OtherFirstName: | DEBORAH | ||||||||
| OtherMiddleName: | L | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | FNP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 97 GREAT TEAYS BLVD | ||||||||
| Address2: | STE 6 | ||||||||
| City: | SCOTT DEPOT | ||||||||
| State: | WV | ||||||||
| PostalCode: | 255609815 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3047576999 | ||||||||
| FaxNumber: | 3042015019 | ||||||||
| Practice Location | |||||||||
| Address1: | 515 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 251301417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043690393 | ||||||||
| FaxNumber: | 3043690371 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2015 | ||||||||
| LastUpdateDate: | 10/14/2019 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 56889 | WV | N | Nursing Service Providers | Registered Nurse | 363LF0000X | APRN56889FNPBC | WV | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 003296899 | 01 | WV | HIGHMARK BCBS | OTHER | 3810029686 | 05 | WV | MEDICAID |