Provider Demographics
NPI:1396922738
Name:DOWNUM, ANGELA J (LVN)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:J
Last Name:DOWNUM
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:AHERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:324 CRYSTAL CITY HWY
Mailing Address - Street 2:
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78801-6124
Mailing Address - Country:US
Mailing Address - Phone:830-278-1243
Mailing Address - Fax:830-278-3095
Practice Address - Street 1:819 WATER ST STE 300
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5330
Practice Address - Country:US
Practice Address - Phone:830-258-5430
Practice Address - Fax:830-792-5771
Is Sole Proprietor?:No
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX158866164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX158866OtherLVN LICENSE