=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912708348
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MANDY DOWNEY APRN, PMHNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/21/2025
-----------------------------------------------------
Last Update Date | 06/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6119 N DAVIS LN TELEHEALTH PRACTICE
-----------------------------------------------------
City | HOBBS
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 88242-0813
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 575-318-1599
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1781 N TURNER ST # 1049
-----------------------------------------------------
City | HOBBS
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 88240-3801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 84417
-----------------------------------------------------
License Number State | NM
-----------------------------------------------------