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General NPI Number Information
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NPI Number | 1356596118
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Entity Type | Individual
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Provider Name | DORA MCGOVERN RN
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Gender | Female
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Dates
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Enumeration Date | 11/20/2008
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Last Update Date | 11/20/2008
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Provider Practice Location Address
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Address Line | 2251 S OTONDO DR
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City | YUMA
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State | AZ
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Zip | 85365-8843
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Country | US
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Telephone | 928-344-8150
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Fax | 928-344-8168
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Provider Business Mailing Address
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Address Line | 1200 RODEO DR
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City | IMPERIAL
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State | CA
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Zip | 92251-2097
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Country | US
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Telephone | 760-455-8729
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | TRN155250
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License Number State | AZ
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