Provider Demographics
NPI:1881365484
Name:DOWNING, QUATAVIUS
Entity type:Individual
Prefix:
First Name:QUATAVIUS
Middle Name:
Last Name:DOWNING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 W SAINT JAMES ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:TARBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27886-4931
Mailing Address - Country:US
Mailing Address - Phone:984-368-1634
Mailing Address - Fax:
Practice Address - Street 1:700 W SAINT JAMES ST UNIT A
Practice Address - Street 2:
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886-4931
Practice Address - Country:US
Practice Address - Phone:984-368-1634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1270163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
0914OtherPIN CODE