MEDICARE: JERI DOWNEY FNP

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	207Q00000X	Family Medicine Physician	APRN.CNP.0030755	OH
2	363LF0000X	Family Nurse Practitioner	APRN.CNP.0030755	OH

General Provider Information

NPI Number	:	1528714888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JERI DOWNEY FNP

Provider Business Mailing Address
First Line	:	1 PRESTIGE PL STE 550
Second Line	:
City	:	MIAMISBURG
State	:	OH
Zip	:	45342-6115
Country	:	US
Telephone Number	:	937-762-1310
Fax Number	:	937-522-8068

Provider Business Practice Location Address
First Line	:	7700 WASHINGTON VILLAGE DR STE 120
Second Line	:
City	:	CENTERVILLE
State	:	OH
Zip	:	45459-4071
Country	:	US
Telephone Number	:	937-425-4144
Fax Number	:	937-425-4146

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

Provider Enumeration Date	:	02/25/2022
Last Update Date	:	09/13/2024

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