Provider Demographics
NPI:1942496427
Name:TOWNE, ANGELA JO (ARNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:JO
Last Name:TOWNE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1641 BOULDER ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-3112
Mailing Address - Country:US
Mailing Address - Phone:712-260-1811
Mailing Address - Fax:
Practice Address - Street 1:46 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:SKOWHEGAN
Practice Address - State:ME
Practice Address - Zip Code:04976-1481
Practice Address - Country:US
Practice Address - Phone:207-474-5121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP231510363LP0200X
IAC088852363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0254656 MEDICAID GROMedicaid
IA0638593 MEDIPASSMedicaid
IA168506 SHELDON RHCMedicare PIN
IA0638593 MEDIPASSMedicaid
IA0254656 MEDICAID GROMedicaid