Provider Demographics
NPI:1235657339
Name:DOWNEY, KATHLEEN ANN (RN)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ANN
Last Name:DOWNEY
Suffix:
Gender:F
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:ELEMENT CARE INC
Mailing Address - Street 2:37 FRIEND STREET
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902
Mailing Address - Country:US
Mailing Address - Phone:781-715-6608
Mailing Address - Fax:781-715-6699
Practice Address - Street 1:ELEMENT CARE
Practice Address - Street 2:166D CUMMINGS CENTER
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915
Practice Address - Country:US
Practice Address - Phone:978-712-3389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-08
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN165810163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse