Provider Demographics
NPI:1578533956
Name:GOVERNO, SCOTT W (FNP/PNP)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:W
Last Name:GOVERNO
Suffix:
Gender:M
Credentials:FNP/PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15268
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28813-0268
Mailing Address - Country:US
Mailing Address - Phone:828-250-2833
Mailing Address - Fax:828-665-8275
Practice Address - Street 1:11 VANDERBILT PARK DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1700
Practice Address - Country:US
Practice Address - Phone:828-213-1822
Practice Address - Fax:828-213-1785
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201940363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2592292Medicare ID - Type Unspecified