Provider Demographics
NPI:1568910578
Name:DOWNING, JESSICA
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:DOWNING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USNS GUAM
Mailing Address - Street 2:PCS 7638
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96666-2802
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:USNS GUAM
Practice Address - Street 2:PCS 7638
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96666-2802
Practice Address - Country:US
Practice Address - Phone:671-344-9730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman