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NPI Code Detail

MEDICARE: MAURA A MCGOVERN NP

MEDICARE: MAURA A MCGOVERN NP
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
1363LF0000XFamily Nurse Practitioner17331MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2NP0891OTHERMABCBS OF MA

General Provider Information

NPI Number : 1073515755
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAURA A MCGOVERN NP
Provider Business Mailing Address
First Line : 27 CENTENNIAL DR
Second Line :
City : PEABODY
State : MA
Zip : 01960-7901
Country : US
Telephone Number : 978-531-7677
Fax Number : 978-531-7690
Provider Business Practice Location Address
First Line : 27 CENTENNIAL DR
Second Line :
City : PEABODY
State : MA
Zip : 01960-7901
Country : US
Telephone Number : 978-531-7677
Fax Number : 978-531-7690
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2005
Last Update Date : 09/22/2010

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1922004803 — FENG GE MD
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1932197282 — J JEFFERY SEMAAN MD
Practice Location Address:
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1689662504 — DONALD L KLEYKAMP MD
Practice Location Address:
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01960-7901
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Practice Fax: 978-531-7690

Directions to “ MAURA A MCGOVERN NP” Practice Location

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