Provider Demographics
NPI:1144560996
Name:DOWNTON, LISA RAE (CNM)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:RAE
Last Name:DOWNTON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-912-6500
Mailing Address - Fax:859-442-1501
Practice Address - Street 1:351 CENTRE VIEW BLVD
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3477
Practice Address - Country:US
Practice Address - Phone:859-331-4665
Practice Address - Fax:859-331-6370
Is Sole Proprietor?:No
Enumeration Date:2013-02-15
Last Update Date:2025-04-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY3008221367A00000X
OH14302-NM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0087193Medicaid
KY7100261840Medicaid
KY7100261840Medicaid