MEDICARE: MRS. MAKAYLA DOWNS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	5006972	NC

General Provider Information

NPI Number	:	1073929980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MAKAYLA DOWNS

Provider Business Mailing Address
First Line	:	1520 SUNDAY DR STE 309
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27607-5254
Country	:	US
Telephone Number	:	919-354-7077
Fax Number	:	919-354-7075

Provider Business Practice Location Address
First Line	:	1520 SUNDAY DR STE 309
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27607-5254
Country	:	US
Telephone Number	:	919-354-7077
Fax Number	:	919-354-7075

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2014
Last Update Date	:	02/15/2024

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