Provider Demographics
NPI:1477109569
Name:DOWNING, SHANNON D (SHANNON DOWNING)
Entity Type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:D
Last Name:DOWNING
Suffix:
Gender:F
Credentials:SHANNON DOWNING
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:D
Other - Last Name:DOWNING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SHANNON DOWNING RN
Mailing Address - Street 1:328 MAURICE ST
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332-4114
Mailing Address - Country:US
Mailing Address - Phone:856-364-6627
Mailing Address - Fax:
Practice Address - Street 1:328 MAURICE ST
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332-4114
Practice Address - Country:US
Practice Address - Phone:856-364-6627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR2098240163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0450399810OtherHOME CARE SERVICES