Individual
JACLYN MCGOWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 FRUIT ST, MGH ELLISON 18 PEDIATRICS, BOSTON, MA 02114-2621
(617) 724-5810
Mailing address
55 FRUIT ST, MGH ELLISON 18 PEDIATRICS, BOSTON, MA 02114-2621
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN283317
MA
Other
Enumeration date
06/14/2013
Last updated
06/14/2013
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