Provider Demographics
NPI:1215233416
Name:DOWNEY, JODI LEE (LPN)
Entity type:Individual
Prefix:MRS
First Name:JODI
Middle Name:LEE
Last Name:DOWNEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 CHESTERFIELD LN
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-2228
Mailing Address - Country:US
Mailing Address - Phone:419-787-0110
Mailing Address - Fax:
Practice Address - Street 1:426 CHESTERFIELD LN
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-2228
Practice Address - Country:US
Practice Address - Phone:419-787-0110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-04
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN12166-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse