Jolene McGowan

Individual provider Active NPI Licensed Practical Nurse · Marlboro, NY

NPI 1124438569 · NPPES record last updated May 7, 2014

Key facts

NPI
1124438569
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
318397-1 (NY)
Practice address
392 Plattekill Rd
Marlboro, NY 12542-5810
Phone
(845) 248-7557
NPI assigned
May 7, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
318397-1NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 318397-1 NY Yes

Addresses

Primary practice location

392 Plattekill Rd
Marlboro, NY 12542-5810

Mailing address

392 Plattekill Rd
Marlboro, NY 12542-5810
Phone (845) 248-7557

Other providers in Marlboro, NY

All providers in Marlboro, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.