Healthcare Provider Details

I. General information

NPI: 1356311377
Provider Name (Legal Business Name): MARY BETH DOWNS A.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

278 LASALLE LEFALL DR
QUINCY FL
32351-5324
US

IV. Provider business mailing address

3614 FLAT RD
TALLAHASSEE FL
32303-7226
US

V. Phone/Fax

Practice location:
  • Phone: 850-875-7200
  • Fax: 850-875-3618
Mailing address:
  • Phone: 850-562-2529
  • Fax: 850-875-3618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberARNP1196912
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: