Provider Demographics
NPI:1861647844
Name:DOWNING, CARMELLA ANNE (PA)
Entity Type:Individual
Prefix:MRS
First Name:CARMELLA
Middle Name:ANNE
Last Name:DOWNING
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:CARMELLA
Other - Middle Name:ANNE
Other - Last Name:PETERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1470 MEDICAL PARKWAY
Mailing Address - Street 2:SUITE 160
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-1576
Mailing Address - Country:US
Mailing Address - Phone:775-445-7650
Mailing Address - Fax:775-882-4218
Practice Address - Street 1:1470 MEDICAL PARKWAY
Practice Address - Street 2:SUITE 160
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-1576
Practice Address - Country:US
Practice Address - Phone:775-445-7650
Practice Address - Fax:775-882-4218
Is Sole Proprietor?:No
Enumeration Date:2008-11-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA1134363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVPA1134OtherMEDICAL LICENSE