Provider Demographics
NPI:1578827564
Name:TOWNSEL, KILA INEZ (LPN)
Entity type:Individual
Prefix:
First Name:KILA
Middle Name:INEZ
Last Name:TOWNSEL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4844 TAMARACK BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-5684
Mailing Address - Country:US
Mailing Address - Phone:614-678-4627
Mailing Address - Fax:
Practice Address - Street 1:4844 TAMARACK BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-5684
Practice Address - Country:US
Practice Address - Phone:614-678-4627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.122578164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse