MEDICARE: MS. KYRA CORINNE DOWNING PAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	C5-0000643	DE

General Provider Information

NPI Number	:	1508010513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KYRA CORINNE DOWNING PAC

Provider Business Mailing Address
First Line	:	121 BECKS WOODS DR
Second Line	:	SUITE 100
City	:	BEAR
State	:	DE
Zip	:	19701-3833
Country	:	US
Telephone Number	:	302-261-5600
Fax Number	:	302-832-4302

Provider Business Practice Location Address
First Line	:	121 BECKS WOODS DR
Second Line	:	SUITE 100
City	:	BEAR
State	:	DE
Zip	:	19701-3833
Country	:	US
Telephone Number	:	302-261-5600
Fax Number	:	302-836-4302

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2008
Last Update Date	:	11/27/2023

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