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Individual

KELLY BROOKS MCGOWAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPNP-AC

Contact information

Practice address
1405 CLIFTON RD NE FL 4, ATLANTA, GA 30322-4052
(703) 609-9148
Mailing address
7570 EASTON VALLEY LN, CUMMING, GA 30028-8976
(703) 609-9148

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN285784
GA
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
RN285784
GA

Other

Enumeration date
11/15/2019
Last updated
08/08/2024
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