Provider Demographics
NPI:1801222997
Name:GOVAN, JOANNE
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:GOVAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:
Other - Last Name:GOVAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN, BS
Mailing Address - Street 1:303 MEYER RD APT 1207
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-2058
Mailing Address - Country:US
Mailing Address - Phone:585-309-0938
Mailing Address - Fax:
Practice Address - Street 1:1412 SWEET HOME RD STE 3
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2795
Practice Address - Country:US
Practice Address - Phone:716-589-1411
Practice Address - Fax:716-204-0670
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-19
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2671431-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse