Individual
COLLEEN GOWANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1160 E 3900 S STE 3100, SALT LAKE CITY, UT 84124-1202
(801) 262-2806
(801) 262-2023
Mailing address
PO BOX 281490, ATLANTA, GA 30384-1490
(801) 771-7717
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
7538941-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689721219
—
UT
Enumeration date
12/26/2020
Last updated
09/29/2021
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