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Individual

MARY MCGOWAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
3410 FUTURES DR, SOUTH SIOUX CITY, NE 68776-3917
(402) 412-7242
(712) 252-5920
Mailing address
600 N SIOUX POINT RD, DAKOTA DUNES, SD 57049-5000
(605) 232-3332
(605) 232-0854

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
111952
NE
363LF0000X
Family Nurse Practitioner
A091311
IA
363LF0000X
Family Nurse Practitioner
CP000341
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1093757999
IA
05
1093757999
NE
05
1093757999
SD
Enumeration date
06/12/2006
Last updated
06/14/2021
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