MEDICARE: GAY LOGAN-DOWNER

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	363LF0000X	Family Nurse Practitioner	APRN-NP339774	GA

General Provider Information

NPI Number	:	1770942641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAY LOGAN-DOWNER

Provider Business Mailing Address
First Line	:	PO BOX 531059
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30353-1059
Country	:	US
Telephone Number	:	404-458-7784
Fax Number	:	404-868-6345

Provider Business Practice Location Address
First Line	:	8735 DUNWOODY PL # 8456
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30350-2995
Country	:	US
Telephone Number	:	404-458-7784
Fax Number	:	404-868-6345

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

Provider Enumeration Date	:	02/19/2016
Last Update Date	:	05/11/2026

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