Individual
MRS. MARLISA GAYLE MCGOWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1335 E REPUBLIC RD, SUITE D, SPRINGFIELD, MO 65804-7248
(417) 363-3900
(417) 313-9998
Mailing address
1335 E REPUBLIC RD, SUITE D, SPRINGFIELD, MO 65804-7248
(417) 363-3900
(417) 313-9998
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2015018288
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295119220
—
MO
Enumeration date
07/20/2015
Last updated
11/03/2025
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