Provider Demographics
NPI:1437732211
Name:GOWER, KATHY D (LPN)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:D
Last Name:GOWER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 DON KNOTTS BLVD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-6838
Mailing Address - Country:US
Mailing Address - Phone:304-284-0025
Mailing Address - Fax:304-284-0025
Practice Address - Street 1:53 DON KNOTTS BLVD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-6838
Practice Address - Country:US
Practice Address - Phone:304-284-0025
Practice Address - Fax:304-284-0025
Is Sole Proprietor?:No
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV37638164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse