Healthcare Provider Details

I. General information

NPI: 1912708348
Provider Name (Legal Business Name): MANDY DOWNEY APRN, PMHNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6119 N DAVIS LN TELEHEALTH PRACTICE
HOBBS NM
88242-0813
US

IV. Provider business mailing address

1781 N TURNER ST # 1049
HOBBS NM
88240-3801
US

V. Phone/Fax

Practice location:
  • Phone: 575-318-1599
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number84417
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: