Provider Demographics
NPI:1730531419
Name:DOWNER, CHARMAINE (FNP)
Entity type:Individual
Prefix:
First Name:CHARMAINE
Middle Name:
Last Name:DOWNER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2615 PADDOCK POINT PL
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-7572
Mailing Address - Country:US
Mailing Address - Phone:352-205-6891
Mailing Address - Fax:
Practice Address - Street 1:1580 BOGGS RD
Practice Address - Street 2:#700
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-1229
Practice Address - Country:US
Practice Address - Phone:770-255-0790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN213607363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily