Provider Demographics
NPI:1538463807
Name:MCGOWIN, CASEY FINN (RN, NP)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:FINN
Last Name:MCGOWIN
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 2340
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11969
Mailing Address - Country:US
Mailing Address - Phone:631-283-2430
Mailing Address - Fax:
Practice Address - Street 1:386 MONTAUK HWY
Practice Address - Street 2:SUITE 5
Practice Address - City:WAINSCOTT
Practice Address - State:NY
Practice Address - Zip Code:11975-2000
Practice Address - Country:US
Practice Address - Phone:631-537-3765
Practice Address - Fax:631-537-4296
Is Sole Proprietor?:No
Enumeration Date:2010-12-30
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305541363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health