| Organization Name: | TOWNLINE MEDICAL CLINIC LLC |
| NPI Number: | 1811310733 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CRYSTAL JEAN JOHNSON (OWNER/SOLE MEMBER) |
| Mailing Address: | 1332 E Main St Lamoni |
| State: | IA US |
| Postal Code: | 501406311 |
| Phone Number: | 6417847526 |
| Fax Number: | 6417847526 |
| NPI Enumeration Date: | 01/29/2014 |
| NPI Last Update Date: | 06/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | A92500 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |