Provider Demographics
NPI:1558511402
Name:DOWNING, KIM D
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:D
Last Name:DOWNING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BLDG 301, ANDREWS AVE.
Mailing Address - Street 2:LYSTER ARMY HEALTH CLINIC
Mailing Address - City:FPO
Mailing Address - State:AA
Mailing Address - Zip Code:36362-5333
Mailing Address - Country:US
Mailing Address - Phone:334-255-7883
Mailing Address - Fax:334-255-7368
Practice Address - Street 1:BLDG 301, ANDREWS AVE.
Practice Address - Street 2:LYSTER ARMY HEALTH CLINIC
Practice Address - City:FPO
Practice Address - State:AA
Practice Address - Zip Code:36362-5333
Practice Address - Country:US
Practice Address - Phone:334-255-7883
Practice Address - Fax:334-255-7368
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2-022297164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse