Healthcare Provider Details

I. General information

NPI: 1639046451
Provider Name (Legal Business Name): JACOB STEPHEN DOWNS CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2025
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 N HIGLEY RD
GILBERT AZ
85234-1604
US

IV. Provider business mailing address

14553 HUNTERS GROVE AVE
EL PASO TX
79938-9501
US

V. Phone/Fax

Practice location:
  • Phone: 480-543-2000
  • Fax:
Mailing address:
  • Phone: 801-318-0532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number333161
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: