Provider Demographics
NPI:1659695443
Name:MCGOWAN, BONNIE (NP)
Entity Type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:
Last Name:MCGOWAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 REDPOLL LOOP
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-0545
Mailing Address - Country:US
Mailing Address - Phone:805-680-0003
Mailing Address - Fax:
Practice Address - Street 1:3687 VETERANS DR
Practice Address - Street 2:PATIENT CARE SERVICES/ NURSING (118)
Practice Address - City:FORT HARRISON
Practice Address - State:MT
Practice Address - Zip Code:59636-9703
Practice Address - Country:US
Practice Address - Phone:406-447-7019
Practice Address - Fax:406-447-7968
Is Sole Proprietor?:No
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA665787163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice