Provider Demographics
NPI:1235500588
Name:DOWNEY, ERIN E (PA)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:E
Last Name:DOWNEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1265 W AMERICAN DR STE 100
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-1405
Mailing Address - Country:US
Mailing Address - Phone:920-886-8979
Mailing Address - Fax:920-886-2225
Practice Address - Street 1:1265 W AMERICAN DR STE 100
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-1405
Practice Address - Country:US
Practice Address - Phone:920-886-8979
Practice Address - Fax:920-886-2225
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3593363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100049172Medicaid