MEDICARE: KENNETH R DOWNING PH.D.

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	103T00000X	Psychologist	332	NE

General Provider Information

NPI Number	:	1508877614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH R DOWNING PH.D.

Provider Business Mailing Address
First Line	:	14030 S 68TH ST.
Second Line	:
City	:	ROCA
State	:	NE
Zip	:	68430
Country	:	US
Telephone Number	:	402-792-3147
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 P ST
Second Line	:	STE. 305
City	:	LINCOLN
State	:	NE
Zip	:	68508-1356
Country	:	US
Telephone Number	:	402-420-6621
Fax Number	:

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

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	07/08/2007

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Directions to “ KENNETH R DOWNING PH.D.” Practice Location

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