Provider Demographics
NPI:1033700208
Name:GOWAN, KAYLIN CARYN (RN)
Entity Type:Individual
Prefix:
First Name:KAYLIN
Middle Name:CARYN
Last Name:GOWAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 FLUVANNA AVE
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701
Mailing Address - Country:US
Mailing Address - Phone:716-499-6261
Mailing Address - Fax:
Practice Address - Street 1:36 FLUVANNA AVE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701
Practice Address - Country:US
Practice Address - Phone:716-499-6261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY753744163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse