Kelly K Gowens, ACNPC-AG

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

2018034800 Issued in MO

Practice address

10010 Kennerly Rd
Saint Louis, MO 63128-2106

Phone

(314) 525-1328

Fax

(314) 525-1728

NPI assigned

Sep 25, 2018

Last updated

Sep 26, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1619452729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10010 KENNERLY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282106",
            "telephone_number": "314-525-1328",
            "fax_number": "314-525-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 KENNERLY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282106",
            "telephone_number": "314-525-1328",
            "fax_number": "314-525-1728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOWENS",
        "first_name": "KELLY",
        "middle_name": "K",
        "credential": "ACNPC-AG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-25",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2018034800",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2018034800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jake Govro, OTD, OTR/L
• Kushi Shashidhar Gowda, MD
• Supreeth Narayana Gowda, MBBS
• Gowdy Enterprises, LLC (1st Choice In Home Care Services)
• Melanie Gowdy, MSW
• Bella Goyal, M.D.
• Manu Shri Goyal, MD
• Sagun D Goyal, M.D.
• Christine Maria Grab, LPTA
• Jonathan Thomas Grabe, M.D.

• Adult Health Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.