Provider Demographics
NPI:1730959354
Name:DOWNING, JASON RICHARD
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:RICHARD
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 1:542 S 3040 W
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-5636
Mailing Address - Country:US
Mailing Address - Phone:801-857-8214
Mailing Address - Fax:
Practice Address - Street 1:542 S 3040 W
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-5636
Practice Address - Country:US
Practice Address - Phone:801-857-8214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-04
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7782242-3102163WN0002X
390200000X
UT7782242-4405363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program