Provider Demographics
NPI:1558742601
Name:GOWLAND, BRITTANY (PA-C)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:GOWLAND
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2016 LANDRY CT
Mailing Address - Street 2:
Mailing Address - City:MERAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70075-2852
Mailing Address - Country:US
Mailing Address - Phone:504-296-4478
Mailing Address - Fax:
Practice Address - Street 1:2016 LANDRY CT
Practice Address - Street 2:
Practice Address - City:MERAUX
Practice Address - State:LA
Practice Address - Zip Code:70075-2852
Practice Address - Country:US
Practice Address - Phone:504-296-4478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-15
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPA.200815363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2395912Medicaid
MS08022561Medicaid
LA423369YH3UMedicare PIN