Provider Demographics
NPI:1790437895
Name:DOWNS, LENORA DIANE (NP)
Entity Type:Individual
Prefix:MRS
First Name:LENORA
Middle Name:DIANE
Last Name:DOWNS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 PIGEON ROOST RD
Mailing Address - Street 2:
Mailing Address - City:BYHALIA
Mailing Address - State:MS
Mailing Address - Zip Code:38611-9213
Mailing Address - Country:US
Mailing Address - Phone:901-603-9882
Mailing Address - Fax:
Practice Address - Street 1:6025 PRIMACY PKWY
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-5763
Practice Address - Country:US
Practice Address - Phone:901-767-1040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR876630163WG0000X
TN30966363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice