Provider Demographics
NPI:1881963619
Name:MCGOWAN, ELIZABETH ROGERS (FNP)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ROGERS
Last Name:MCGOWAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SHIPS LNDG
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:VA
Mailing Address - Zip Code:23314-2775
Mailing Address - Country:US
Mailing Address - Phone:757-942-1102
Mailing Address - Fax:
Practice Address - Street 1:100 SHIPS LNDG
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:VA
Practice Address - Zip Code:23314-2775
Practice Address - Country:US
Practice Address - Phone:757-942-1102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-22
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2011005161363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily