Provider Demographics
NPI:1609958560
Name:MCGOWAN, LEIGHANNE B (RN)
Entity Type:Individual
Prefix:MRS
First Name:LEIGHANNE
Middle Name:B
Last Name:MCGOWAN
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 1:91648 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97448-9403
Mailing Address - Country:US
Mailing Address - Phone:503-319-2426
Mailing Address - Fax:541-461-2498
Practice Address - Street 1:91648 RIVER RD
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:OR
Practice Address - Zip Code:97448-9403
Practice Address - Country:US
Practice Address - Phone:503-319-2426
Practice Address - Fax:541-461-2498
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR080045345RN163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR052845Medicaid