Provider Demographics
NPI:1912419052
Name:DOWNING, KEVIN LEE (NP)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:LEE
Last Name:DOWNING
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 W. CHARLESTON BLVD.
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102
Mailing Address - Country:US
Mailing Address - Phone:702-383-2688
Mailing Address - Fax:
Practice Address - Street 1:9777 BERMUDA RD # 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89183-3566
Practice Address - Country:US
Practice Address - Phone:008-910-1731
Practice Address - Fax:225-437-3292
Is Sole Proprietor?:No
Enumeration Date:2017-10-30
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV815325363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily