Individual
MR. PAUL A GOBOURNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
8901 WISCONSIN AVE, BLDG. 8 RM 3169C, BETHESDA, MD 20889-5600
(301) 400-1012
(301) 295-8963
Mailing address
1748 PORTAL DR NW, WASHINGTON, DC 20012-1116
(202) 722-7786
(202) 722-1123
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R132556
MD
363LF0000X
Family Nurse Practitioner
RN965066
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035904300
—
DC
Enumeration date
01/29/2008
Last updated
03/02/2017
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