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NPI Code Detail

MEDICARE: SALLY ANNE MCGOWAN RN

MEDICARE:   SALLY ANNE MCGOWAN  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0200XPediatric Registered NurseRN170804MA

General Provider Information

NPI Number : 1417772500
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALLY ANNE MCGOWAN RN
Provider Business Mailing Address
First Line : 405 S MAIN ST
Second Line :
City : COHASSET
State : MA
Zip : 02025-2065
Country : US
Telephone Number : 781-254-6185
Fax Number :
Provider Business Practice Location Address
First Line : 1661 WORCESTER RD STE 501
Second Line :
City : FRAMINGHAM
State : MA
Zip : 01701-5405
Country : US
Telephone Number : 781-254-6185
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2024
Last Update Date : 11/22/2024

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Directions to “ SALLY ANNE MCGOWAN RN” Practice Location

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