Provider Demographics
NPI:1770807778
Name:MCGOWAN, GHANA M (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:GHANA
Middle Name:M
Last Name:MCGOWAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10950 ARROW RTE UNIT 876
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91729-7237
Mailing Address - Country:US
Mailing Address - Phone:937-903-1243
Mailing Address - Fax:
Practice Address - Street 1:1240 ROSECRANS AVE STE 120
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-2558
Practice Address - Country:US
Practice Address - Phone:310-795-8807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-19
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH271349-COA1363LF0000X
OHCOA11338-NP363LF0000X
GARN263628363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCOA11338NPOtherCERTIFIED NURSE PRACTITIONER
GARN263628OtherCERTIFIED NURSE PRACTITIONER