Provider Demographics
NPI:1871378935
Name:DOWNER, BRYAN (RN)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:
Last Name:DOWNER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33232 RICHARD O DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-6116
Mailing Address - Country:US
Mailing Address - Phone:734-718-3764
Mailing Address - Fax:
Practice Address - Street 1:15650 DEERING ST
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-3471
Practice Address - Country:US
Practice Address - Phone:734-299-0669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704315380163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine