Individual
MRS. MARY JO MCGOWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
555 CHEVES STREET, FLORENCE, SC 29506-2617
(843) 777-8752
(843) 777-8705
Mailing address
PO BOX 100551, FLORENCE, SC 29501-0551
(843) 777-8752
(843) 777-8705
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APN297
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN0492
—
SC
Enumeration date
03/31/2006
Last updated
12/20/2011
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