Provider Demographics
NPI:1750032777
Name:MCGOWAN, RHIANNA IRENE (PA-C)
Entity Type:Individual
Prefix:
First Name:RHIANNA
Middle Name:IRENE
Last Name:MCGOWAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1445 STONELAKE COVE AVE APT 14305
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7913
Mailing Address - Country:US
Mailing Address - Phone:702-622-5355
Mailing Address - Fax:702-735-7921
Practice Address - Street 1:2800 E DESERT INN RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-3609
Practice Address - Country:US
Practice Address - Phone:702-731-1616
Practice Address - Fax:702-734-4900
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA2558363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1750032777OtherNPI
NV1750032777Medicaid
NVPA2558OtherNV MEDICAL LICENSE