Provider Demographics
NPI:1891843140
Name:DOWNEY, KRISSA L (AUD)
Entity Type:Individual
Prefix:MS
First Name:KRISSA
Middle Name:L
Last Name:DOWNEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KRISSA
Other - Middle Name:L
Other - Last Name:REISER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:8005 FARNAM DRIVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114
Mailing Address - Country:US
Mailing Address - Phone:402-502-6970
Mailing Address - Fax:402-502-6930
Practice Address - Street 1:8005 FARNAM DRIVE
Practice Address - Street 2:SUITE 204
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114
Practice Address - Country:US
Practice Address - Phone:402-502-6970
Practice Address - Fax:402-502-6930
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE248231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0717975Medicaid
NE100252024-00Medicaid
IA3717975Medicaid
IA7717975Medicaid
IA8717975Medicaid
IA9717975Medicaid
IA1717975Medicaid
NE37015OtherBCBS ENT
NE100252023-00Medicaid
IA5717975Medicaid
IA1717991Medicaid
NE37014OtherBCBS BT
IA2717975Medicaid
IA6717975Medicaid
IA0717991Medicaid
IA4717975Medicaid
IA0717991Medicaid
NEQ58133Medicare UPIN