Individual
JESSICA LAUREN GOWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4001 KRESGE WAY STE 200, LOUISVILLE, KY 40207-4640
(502) 895-1995
Mailing address
1901 CAMPUS PL, LOUISVILLE, KY 40299-2308
(502) 253-4911
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3439
KY
363A00000X
Physician Assistant
TC188
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/13/2024
Last updated
01/09/2025
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