Healthcare Provider Details

I. General information

NPI: 1275426652
Provider Name (Legal Business Name): ALICIA MCGOWAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALICIA BARNETT RN

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3626 HOMEWOOD DR
POWDER SPRINGS GA
30127-5011
US

IV. Provider business mailing address

3626 HOMEWOOD DR
POWDER SPRINGS GA
30127-5011
US

V. Phone/Fax

Practice location:
  • Phone: 404-573-6181
  • Fax:
Mailing address:
  • Phone: 404-573-6181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN243680
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN243680
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License NumberRN243680
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License NumberRN243680
License Number StateGA
# 5
Primary TaxonomyY
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License NumberRN243680
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: