Healthcare Provider Details

I. General information

NPI: 1194118182
Provider Name (Legal Business Name): KRISTEN DOWNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2015
Last Update Date: 03/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 TIMBERLAKE RD
BOSTIC NC
28018-7807
US

IV. Provider business mailing address

326 DEVINEY ST
SPINDALE NC
28160-1110
US

V. Phone/Fax

Practice location:
  • Phone: 828-980-3596
  • Fax:
Mailing address:
  • Phone: 828-980-9536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: