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General NPI Number Information
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NPI Number | 1912725359
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Entity Type | Individual
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Provider Name | TREVOR A. MCGOWAN CNP
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Gender | Male
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 5333 MCAULEY DR RM 4012
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City | YPSILANTI
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State | MI
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Zip | 48197-1099
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Country | US
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Telephone | 734-572-1141
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Fax |
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Provider Business Mailing Address
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Address Line | 24 FRANK LLOYD WRIGHT DR STE J2000
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City | ANN ARBOR
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State | MI
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Zip | 48105-9484
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Country | US
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Telephone | 734-747-6766
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704350790
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License Number State | MI
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