Healthcare Provider Details

I. General information

NPI: 1205729894
Provider Name (Legal Business Name): JESSI DAWN DOWNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3307 N DIXIELAND RD
ROGERS AR
72756-6816
US

IV. Provider business mailing address

PO BOX 130
ROGERS AR
72757-0130
US

V. Phone/Fax

Practice location:
  • Phone: 479-986-5150
  • Fax: 479-986-5150
Mailing address:
  • Phone: 479-986-5150
  • Fax: 479-986-5191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number203134
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: