Basic Information
Provider Information
NPI: 1669107512
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOWNS
FirstName: MIRANDA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
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OtherLastName:  
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OtherCredential:  
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Mailing Information
Address1: 2801 PURCELL ST
Address2:  
City: BRIGHTON
State: CO
PostalCode: 806013551
CountryCode: US
TelephoneNumber: 3036599700
FaxNumber: 7203363989
Practice Location
Address1: 2801 PURCELL ST
Address2:  
City: BRIGHTON
State: CO
PostalCode: 806013551
CountryCode: US
TelephoneNumber: 3036599700
FaxNumber: 7203363989
Other Information
ProviderEnumerationDate: 07/22/2022
LastUpdateDate: 07/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XAPN.0997765COY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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