Provider Demographics
NPI:1912708348
Name:DOWNEY, MANDY (RN)
Entity type:Individual
Prefix:
First Name:MANDY
Middle Name:
Last Name:DOWNEY
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6119 N DAVIS LN
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88242-0813
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6119 N DAVIS LN
Practice Address - Street 2:TELEHEALTH PRACTICE
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88242-0813
Practice Address - Country:US
Practice Address - Phone:575-318-1599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRN-76045363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health