Individual
NIKKI-ANN GILIAM MCGOVERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2415 N ORANGE AVE STE 302, ORLANDO, FL 32804-5505
(407) 303-7250
(407) 303-7255
Mailing address
2415 N ORANGE AVE STE 302, ORLANDO, FL 32804-5505
(407) 303-7250
(407) 303-7255
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9103180
FL
363AM0700X
Medical Physician Assistant
Primary
PA9103180
FL
Other
Enumeration date
10/12/2006
Last updated
09/10/2020
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