Individual
COURTNEY GAVIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
396 BROADWAY, KINGSTON, NY 12401-4626
(845) 331-3131
Mailing address
396 BROADWAY, KINGSTON, NY 12401-4626
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1521377
NY
Other
Enumeration date
09/26/2021
Last updated
09/26/2021
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