Healthcare Provider Details

I. General information

NPI: 1447170592
Provider Name (Legal Business Name): STEPHANIE MCGOWN AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4960 HARLEM RD
AMHERST NY
14226-2560
US

IV. Provider business mailing address

799 CASEY RD
EAST AMHERST NY
14051-1436
US

V. Phone/Fax

Practice location:
  • Phone: 716-748-7640
  • Fax:
Mailing address:
  • Phone: 315-521-0378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number312682
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: