Provider Demographics
NPI:1992030175
Name:MCGOWAN, CHERYL LOUISE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:LOUISE
Last Name:MCGOWAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:CHERYL
Other - Middle Name:LOUISE
Other - Last Name:LAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:1020 HITT STREET
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65212-0001
Practice Address - Country:US
Practice Address - Phone:573-882-8788
Practice Address - Fax:573-882-3131
Is Sole Proprietor?:No
Enumeration Date:2009-10-06
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO083630363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily