Provider Demographics
NPI:1992255186
Name:DOWNS, LISA (APRN-CNP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:DOWNS
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 BECK AVE # MS 32-200
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-6804
Mailing Address - Country:US
Mailing Address - Phone:707-784-8600
Mailing Address - Fax:
Practice Address - Street 1:3811 W GORE BLVD STE 6
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-6328
Practice Address - Country:US
Practice Address - Phone:580-250-6525
Practice Address - Fax:580-354-5930
Is Sole Proprietor?:No
Enumeration Date:2016-10-11
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0048821363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner