Healthcare Provider Details

I. General information

NPI: 1740641596
Provider Name (Legal Business Name): TONIKA DOWNING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2016
Last Update Date: 03/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 CLIPPER DR
NEWPORT NEWS VA
23602-6340
US

IV. Provider business mailing address

122 CLIPPER DR
NEWPORT NEWS VA
23602-6340
US

V. Phone/Fax

Practice location:
  • Phone: 757-812-2544
  • Fax: 757-512-8012
Mailing address:
  • Phone: 757-812-2544
  • Fax: 757-512-8012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number549567
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number549567
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: