Individual
KELLY B GOWDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
8060 WOLF RIVER BLVD, GERMANTOWN, TN 38138-1727
(901) 271-1000
(901) 271-4187
Mailing address
8060 WOLF RIVER BLVD, GERMANTOWN, TN 38138-1727
(901) 271-1000
(901) 271-4187
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R892458
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R892458
MS CNP LICENSE
MS
Enumeration date
06/11/2013
Last updated
12/30/2013
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