Basic Information
Provider Information
NPI: 1679123814
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCGOWEN
FirstName: JOY
MiddleName: LINDA
NamePrefix:  
NameSuffix:  
Credential: FNP-BC, RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3701 S BROADWAY
Address2:  
City: ENGLEWOOD
State: CO
PostalCode: 801133611
CountryCode: US
TelephoneNumber: 3033606276
FaxNumber: 3037612787
Practice Location
Address1: 3292 PEORIA ST
Address2:  
City: AURORA
State: CO
PostalCode: 800101517
CountryCode: US
TelephoneNumber: 3033606276
FaxNumber: 3033430664
Other Information
ProviderEnumerationDate: 09/19/2019
LastUpdateDate: 01/10/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/10/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN.1634081CON Nursing Service ProvidersRegistered Nurse 
363LF0000XAPN.0994830-NPCOY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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